Pattern of antimicrobial resistance in the pre and during COVID-19 era: An observational study.

Kishk, Rania; Abu Bakr, Noha M; Anani, Maha; Nemr, Nader; Salama, Bassam; Samahy, Mohammed; Kishk, Safaa M.; Salem, Naglaa E.; Mohamed, Hasnaa A.

doi:10.21608/mid.2023.217092.1539

Pattern of antimicrobial resistance in the pre and during COVID-19 era: An observational study.

Document Type : Original Article

Authors

¹ Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt.

² Public Health, Community, Occupational and Environmental Medicine, Suez Canal University Faculty of Medicine, Ismailia 41522, Egypt. Department of Basic Medical Sciences, Faculty of Medicine, King Salman International University, South Sinai, Egypt.

³ Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt.

⁴ Endemic and Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt.

⁵ Neuropsychiatry department, Faculty of Medicine, Suez Canal University, Ismailia 41511, Egypt.

⁶ Pharmaceutical Medicinal Chemistry Department, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt.

10.21608/mid.2023.217092.1539

Abstract

Background: World Health Organization has documented the exaggerated use of broad-spectrum antibiotics during the COVID-19 pandemic raising warnings of increasing antimicrobial resistance. Aim: This is an observational cross-sectional comparative study that was done to describe the pattern of antibiotics resistance before and during the COVID-19 era to explain if this pattern is affected with using different antibiotics in COVID-19 era. Methods: Various clinical specimens from patients admitted in the urology, internal medicine, surgery inwards, intensive care unit and neonatal ICU in Suez Canal University Hospital in the pre-COVID-19 period (January 2019 to January 2020) and during COVID-19 pandemic (January 2020 to January 2021) were included. 627 patients,349 (55.6%) patients in the pre-COVID-19 era and 278 (44.4%) patients during the COVID-19 era. Results: Most samples were Gram-negative organisms (86%), while gram-positive represent 14% only. The most common Gram-negative isolates include Escherichia coli (E. coli) (30.9%). The most common Gram-positive is Staphylococcus species (11.8%). The study found a statistically significant increase in the resistance for cefazoline (p=0.002), nitrofurantoin (p=<0.001), aztreonam (p=<0.001) and tobramycin (p=<0.001) during the COVID-19 era compared with the pre-COVID-19 era. Among the Gram-negative pathogens, there is a significant increase in the resistance for ampicillin (p=0.023), ciprofloxacin (p=0.013), nitrofurantoin (p=<0.001), aztreonam (p=<0.001), tobramycin (p=0.035), trimethoprim -sulphamethoxazole (p=0.029), cefazoline (p=0.011), aztreonam (p<0.001), tigecyclin (p=0.048), and amikacin (p=0.043) during the COVID-19 compared with before, but the susceptibility pattern for the Gram-positive pathogens did not vary in both periods. Conclusion: COVID-19 pandemic led to the uncontrolled use of broad-spectrum antimicrobials, causing an increase in the antimicrobials resistance (AMR). Strict adherence to antimicrobial stewardship is essential.

Keywords

Main Subjects