A hospital has correlated an increase in resistance to multiple antimicrobials in Acinetobacter baumannii and Pseudomonas aeruginosa to the onset of the COVID-19 pandemic, according to research conducted in its intensive care unit (ICU). These bacteria, globally implicated in hospital-acquired infections, particularly within ICUs, showed a significant upsurge in resistance following the emergence of COVID-19. The research was led by investigators at the Gazi State Hospital in Samsun, Turkey, and focused on isolates tested between January 2019 and December 2022. They utilized traditional biochemical methods and the advanced VITEK 2 system for identification and antibiotic susceptibility determination.
Compared to 2019, the resistance rates were significantly elevated in subsequent years, coinciding with the commencement of the pandemic. These did not continue to rise throughout the pandemic duration, suggesting a particular impact of the pandemic’s onset on bacterial resistance patterns.
The investigators observed a significant uptick in resistance rates from pre-pandemic to pandemic periods, with some impressive increases noted. For instance, Acinetobacter baumannii showed increased resistance to imipenem from a pre-pandemic rate of 35.1% to 96% during the pandemic. Similar increases were seen in resistance to other antibiotics such as amikacin, ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftazidime. The resistance rates for Pseudomonas aeruginosa also showed substantial increases during the pandemic, particularly for imipenem, colistin, amikacin, ciprofloxacin, and ceftazidime.
The significantly increased resistance rates corresponded with several pandemic influences, including a surge in ICU admissions, prolonged hospital stays, increased use of mechanical ventilation and oxygen support. The crisis also forced a rotation of physicians from diverse specialties in ICUs, making antibiotic practices often fall outside the supervision of infectious disease specialists. Broad-spectrum antibiotics were primarily used as initial treatment and seldom de-escalated, likely contributing to resistance development.
The investigators highly advise closely monitoring resistance patterns and revising antibiotic use rationality during such crises. They emphasize the need for stringent infection control strategies to mitigate resistance and suggest potential benefits of emerging diagnostic biomarkers, like procalcitonin, in guiding stewardship. Restoring specialist oversight in antibiotic selection and utilization is also recommended to halt the progression of antibiotic resistance.
Source: https://www.contagionlive.com/view/a-hospital-relates-rise-in-antimicrobial-resistance-to-pandemic