Impact of the COVID-19 Pandemic on CLABSI Rates and Antibiotic Resistance: A Multicenter Study in Türkiye

Abstract

Objective: The COVID-19 pandemic significantly disrupted infection control practices in healthcare settings. Previous studies have reported increased rates of central line-associated bloodstream infections (CLABSI), particularly during the early stages and peak periods of the pandemic. This multicenter study aimed to evaluate the impact of the COVID-19 pandemic on CLABSI rates in Türkiye over a four-year period from 2019 to 2022. Materials and Methods: We conducted a retrospective analysis of prospectively collected CLABSI data from hospitals across various regions of Türkiye between 2019 and 2022. The study period was divided into three phases: pre-pandemic, early pandemic, and late pandemic. Demographic and clinical characteristics, mortality rates, and microbiological data were analyzed. Pathogen distribution and antibiotic resistance patterns were compared between the pre-pandemic and pandemic periods. Results: A total of 25 hospitals participated in the study. The CLABSI rates per 1000 catheter days were 4.26 in 2019, 4.13 in 2020, 3.68 in 2021, and 3.53 in 2022. Across all periods, 3238 pathogens were identified. Gram-negative bacteria predominated both before and during the pandemic, with Acinetobacter baumannii (18.6%) and Klebsiella pneumoniae (17.8%) being the most common. Notably, an increase in carbapenem and colistin resistance in K. pneu-monia was observed during the pandemic compared to the pre-pandemic period. Conclusions: In Türkiye, the predominant causative agents of CLABSI did not change during the pandemic, with Klebsiella spp. and A. baumannii being most frequently isolated. However, the rise in CLABSI-associated mortality during the pandemic highlights the broader impact of healthcare system disruptions. © 2025 Elsevier B.V., All rights reserved.