The Epidemiology of ESKAPE Pathogens and Clostridioides difficile in patients with and without COVID-19 in hospitals in Tshwane District, Gauteng Province, South Africa.
1
Department of Global Health, Stellenbosch Unviersity, Cape Town, South Africa
2
Medicine Usage in South Africa, North-West University, Potchefstroom, South Africa
3
Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa
4
Division of Surveillance and Outbreak response, National Institute for Communicable Diseases, Johannesburg, South Africa
5
Africa Centres for Disease Control and Prevention, CDC, Addis Ababa, Ethiopia
6
Ethiopian Public Health Institute, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
COVID-19 is a respiratory disease caused by the SARS-CoV-2. This study aimed to compare infections with ESKAPE pathogens and C. difficile and to identify key predictors associated with these bacterial pathogens between patients with and without COVID-19 admitted to the ICU at hospitals in the Tshwane district, South Africa.
METHODS:
We conducted a retrospective cross-sectional analytic study on patients with and without COVID-19 who were admitted to hospitals in the Tshwane District between March 2020 and December 2022. Categorical variables were summarized using frequencies and percentages to describe the distribution of ESKAPE pathogens and Clostridioides difficile. Logistic regression was used to identify factors associated with bacterial infection (presence vs. absence). Variables with a p-value ≤ 0.10 in univariate analysis were included in the multivariate model. Statistical significance was set at p ≤ 0.05.
RESULTS:
This study used a dataset of 4893 clinical isolates from 225 patients with and without COVID-19. ESKAPE pathogens, and Clostridioides difficile were identified in 71.4% (95% CI: 0.701 – 0.726; 3491/4893) of the isolates. Clostridioides difficile (26.0%, 909/3491), Acinetobacter baumannii (24.6%, 860/3491), and Klebsiella pneumoniae (19.9%, 696/3491) were the most frequently identified pathogens. Multivariable analysis showed that both treatment facilities (Hospital A, Hospital B [reference] and Hospital C) (aOR 0.299, 95% CI: 0.190 - 0.470, p <0.001; aOR 0.402, 95% CI: 0.252 - 0.638; p <0.001, respectively) and infection with COVID-19 (aOR 0.604; 95% CI: 0.466 - 0.783; p <0.001) were significantly associated with a decrease in the odds of infection with ESKAPE pathogens and Clostridioides difficile.
CONCLUSIONS:
Infection with COVID-19 and treatment facilities were associated with decreased odds of acquiring infections with ESKAPE pathogens and Clostridioides difficile. Therefore, this study underscores the urgent need for stringent measures and infection control programs to prevent further dissemination.
COVID-19 is a respiratory disease caused by the SARS-CoV-2. This study aimed to compare infections with ESKAPE pathogens and C. difficile and to identify key predictors associated with these bacterial pathogens between patients with and without COVID-19 admitted to the ICU at hospitals in the Tshwane district, South Africa.
METHODS:
We conducted a retrospective cross-sectional analytic study on patients with and without COVID-19 who were admitted to hospitals in the Tshwane District between March 2020 and December 2022. Categorical variables were summarized using frequencies and percentages to describe the distribution of ESKAPE pathogens and Clostridioides difficile. Logistic regression was used to identify factors associated with bacterial infection (presence vs. absence). Variables with a p-value ≤ 0.10 in univariate analysis were included in the multivariate model. Statistical significance was set at p ≤ 0.05.
RESULTS:
This study used a dataset of 4893 clinical isolates from 225 patients with and without COVID-19. ESKAPE pathogens, and Clostridioides difficile were identified in 71.4% (95% CI: 0.701 – 0.726; 3491/4893) of the isolates. Clostridioides difficile (26.0%, 909/3491), Acinetobacter baumannii (24.6%, 860/3491), and Klebsiella pneumoniae (19.9%, 696/3491) were the most frequently identified pathogens. Multivariable analysis showed that both treatment facilities (Hospital A, Hospital B [reference] and Hospital C) (aOR 0.299, 95% CI: 0.190 - 0.470, p <0.001; aOR 0.402, 95% CI: 0.252 - 0.638; p <0.001, respectively) and infection with COVID-19 (aOR 0.604; 95% CI: 0.466 - 0.783; p <0.001) were significantly associated with a decrease in the odds of infection with ESKAPE pathogens and Clostridioides difficile.
CONCLUSIONS:
Infection with COVID-19 and treatment facilities were associated with decreased odds of acquiring infections with ESKAPE pathogens and Clostridioides difficile. Therefore, this study underscores the urgent need for stringent measures and infection control programs to prevent further dissemination.
| eISSN: | 2654-1459 |
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