Carbapenem Resistance Enterobacteriaceae Clinical Impacts among Mechanically Ventilated Covid-19 Infected Patients

Background: Over the last two decades, Carbapenem Resistant Enterobacteriaceae (CRE) related ventilation associated pneumonia (VAP) have increased globally in which infection by these multi-drug resistant GNB increases mortality, morbidity, and cost expenditure. The aim of this study is to investigate the clinical impacts of the CRE related VAP among mechanically ventilated COVID-19 infected. Methods: A retrospective study was conducted in our COVID-19 isolation department at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan between March 2020 and Sep 2021 for all eligible SARS-CoV-2 infected hospitalized patients after they were divided into two comparative groups: Non-CRE related VAP infection cohort (Cohort I) and CRE related VAP infection cohort (Cohort II). An Independent and One-Sample T Tests, and Chi Square Test will be used to analyze the parametric and non-parametric outcomes’ data, respectively. Results: The mean age of the whole studied 51.41±16.44 year. Male patients were distributed in the study in approximately 3:1 ratio to female patients (699 (75.0%) versus 233 (25.0%), respectively, p-value = 0.021). The overall 28-day ICU mortality was detected in 526 in Mechanically Ventilated SARS-CoV-2 infected patients with an overall incidence rate of 56.44% during an average of 19.89±5.55 days and 12.93±4.18 days of ICU and overall hospital admission days, respectively. Cohort I patients compared to Cohort II patients, had an overall 28-day ICU mortality, ICU stay days, and overall hospital admission days of 175 (40.6%),16.19±4.09 days and 22.23±5.63 days compared to 351 (70.06%), 10.13±1.08 days, and 17.88±4.62 days, respectively, p-Value = 0.00). Conclusion: Carbapenem Resistant Enterobacteriaceae associated ventilation associated pneumoniae in mechanically ventilated critically ill SARS-CoV-2 infected patients have at least higher mortality rate and longer overall hospital length of stay compared with patients infected with Non-Carbapenem Resistant Enterobacteriaceae.