Table 2.
Characteristics of Admissions During the Pre–Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic Period and by SARS-CoV-2 Testing Status During the Pandemic
| Characteristic | July 2019–Feb 2020 | SARS-CoV-2 (March 2020–October 2021) | |||
|---|---|---|---|---|---|
| Pre–SARS-CoV-2 | SARS-CoV-2 Positive | SARS-CoV-2 Negative | Not Tested | SARS-CoV-2 Period Total | |
| Total admissions, No. | 1 789 458 | 189 114 | 1 898 651 | 1 641 443 | 3 729 208 |
| Total with ≥1 AMR event overall, No. | 63 263 | 9296 | 77 999 | 42 115 | 129 410 |
| Community onset | 49 420 | 5164 | 59 024 | 33 000 | 97 188 |
| Hospital onset | 13 843 | 4132 | 18 975 | 9115 | 32 222 |
| AMR rate per 1000 admissions | 35.4 | 49.2* | 41.1* | 25.7* | 34.7** |
| Community onset | 27.6 | 27.3* | 31.1* | 20.1* | 26.1** |
| Hospital onset | 7.7 | 21.8* | 10.0* | 5.6* | 8.6** |
| Total antibacterial DOT per 1000 d present | 323.5 | 420.9* | 360.3* | 280.4* | 334.1** |
| % of all admissions prescribed antibacterial therapy | 35.0% | 57.8%* | 40.1%* | 30.4%* | 36.7%** |
| Antibacterial therapy duration, d, avg ± SD (median) | 3.57 ± 4.43 (2) | 5.68 ± 5.97 (4)* | 3.92 ± 4.87 (3)* | 3.28 ± 4.19 (2)* | 3.80 ± 4.75 (2)** |
| % of admissions with a GN/GP pathogen of interest | 9.3% | 11.93%* | 10.96%* | 7.20%* | 9.35% |
| Antibacterial therapy duration, d, avg ± SD (median) | 6.25 ± 6.51 (4) | 9.58 ± 9.08 (7)* | 6.78 ± 7.11 (5)* | 5.63 ± 6.14 (4)* | 6.59 ± 7.03 (5)** |
| % antibacterial therapy duration ≥72 h | 68.85% | 79.20%* | 72.11%* | 63.02%* | 69.49%** |
| % with GN/GP pathogen prescribed antibacterial therapy | 86.08% | 89.86%* | 88.03%* | 82.77%* | 86.37% |
| % of admissions with a negative/no culture resulta | 90.7% | 88.1%* | 89.0%* | 92.8%* | 90.6% |
| Antibacterial therapy duration, d, avg ± SD (median) | 2.98 ± 3.57 (2) | 4.88 ± 4.72 (4)* | 3.24 ± 3.85 (2)* | 2.85 ± 3.56 (2)* | 3.20 ± 3.84 (2)** |
| % antibacterial therapy duration ≥72 h | 17.6% | 41.1%* | 21.0%* | 14.9%* | 19.2%** |
| % prescribed antibacterial therapy | 29.72% | 53.50%* | 34.20%* | 26.31%* | 31.59%** |
| % IET in GN/GP admissions | 20.20% | 25.92%* | 20.36%* | 19.72%* | 20.55%** |
| % IET in AMR admissions | 34.46% | 37.6%* | 35.6%* | 33.8%* | 35.21%** |
| Age, y, avg ± SD (median) | 58.39 ± 19.67 (61) | 61.45 ± 17.91 (63)* | 58.53 ± 19.71 (62)* | 57.46 ± 19.73 (60)* | 58.21 ± 19.65 (61) |
| Male sex, % | 43.13% | 50.24%* | 43.84%* | 42.96%* | 43.78%** |
| Admissions with ≥1 comorbidity, % | 47.13% | 78.39%* | 55.45%* | 44.57% | 51.83%** |
| Hospital LOS, d, avg ± SD (median) | 4.26 ± 5.84 (3) | 7.95 ± 10.47 (5)* | 4.77 ± 7.02 (3)* | 3.92 ± 6.28 (2)* | 4.56 ± 6.98 (3)** |
| ED admission, % | 33.68% | 49.74%* | 37.29%* | 32.47%* | 35.8%** |
| ICU admission, % | 11.94% | 20.84%* | 12.67%* | 9.35%* | 11.62%** |
| ICU LOS, d, avg ± SD (median) | 3.50 ± 4.68 (2) | 8.18 ± 9.70 (5)* | 3.95 ± 5.86 (2)* | 3.37 ± 4.82 (2)* | 4.13 ± 5.99 (2)** |
| Ventilated, % | 1.11% | 6.22% | 1.7%* | 0.83%* | 1.55%** |
| Prior 30-d admission, % | 10.64% | 9.01% | 11.05%* | 10.7% | 10.80%** |
| Prior 90-d admission, % | 16.97% | 13.84% | 19.15%* | 18.17%* | 18.45%** |
Abbreviations: AMR, antimicrobial resistance; avg, average; d, days; DOT, days of therapy; ED, emergency department; GN, gram-negative; GP, gram-positive; ICU, intensive care unit; IET, inadequate empiric therapy; LOS, length of stay; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SD, standard deviation; y, years.
Also includes admissions positive for a GN/GP pathogen not included as a pathogen of interest (1.16% of admissions).
*P < .001 using bivariate analysis of variance and χ2 tests for group differences compared to pre–SARS-CoV-2.
**P < .001 using t test and χ2 tests comparing SARS-CoV-2 total and pre–SARS-CoV-2 periods.