Changes in multidrug-resistant Enterobacteriaceae features among patients in the emergency room during the COVID-19 Omicron variant pandemic
PLOS One·
- DOI
- 10.1371/journal.pone.0355725
- PMID
- —
- PMCID
- —
- OpenAlex
- W7203641012
- Study type
- Cohort study
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings provide article-level context on how multidrug-resistant Enterobacteriaceae characteristics and selected resistance patterns varied across the study's defined pandemic stages in an acute-care setting. The abstract presents these results as relevant to stage-adapted risk assessment and antimicrobial stewardship, but does not establish broader population-level effects.
Structured evidence summary
Research question
The study examined whether factors associated with multidrug-resistant Enterobacteriaceae bloodstream infection and antimicrobial resistance patterns differed across defined phases of the COVID-19 Omicron period among adult emergency department patients.
Study design
This was a retrospective cohort study conducted from January 2022 through January 2023. The analysis used stage-specific association modelling and examined changes in selected bacteria-antibiotic resistance pairs.
Population and setting
The study included adult emergency department patients at a tertiary medical center in Taiwan who had Enterobacteriaceae-positive blood cultures, complete antimicrobial susceptibility results, and met the stated eligibility criteria. Of 1,269 screened patients, 816 were included; 287 had multidrug-resistant Enterobacteriaceae.
Main findings
Associations with multidrug-resistant infection differed by pandemic stage: older age and selected red-cell measures in the first stage, platelet count and ALT at the epidemic peak, and white-cell, neutrophil, haemoglobin, and haematocrit measures in the later stage. Klebsiella pneumoniae retained complete ampicillin resistance and had increasing ciprofloxacin resistance, whereas Escherichia coli had decreasing resistance across several agents.
Public-health relevance
The findings provide article-level context on how multidrug-resistant Enterobacteriaceae characteristics and selected resistance patterns varied across the study's defined pandemic stages in an acute-care setting. The abstract presents these results as relevant to stage-adapted risk assessment and antimicrobial stewardship, but does not establish broader population-level effects.
Important limitations
The retrospective design, single tertiary-care center, restriction to patients with positive blood cultures and complete susceptibility testing, and stage definitions based on national surveillance data limit generalizability and may introduce selection or confounding concerns. This summary relies only on the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of methods, adjustment, and uncertainty.
GIDS interpretation
The article is discoverable under COVID-19, Taiwan, and surveillance-related classifications and provides context about antimicrobial resistance findings during defined Omicron-period stages. It should not be interpreted as confirmation of a current or external surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 6 auditable classifier relationships to diseases, places, topics, and study design.