Increased Antimicrobial Consumption, Isolation Rate, and Resistance Profiles of Multi-Drug Resistant Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii During the COVID-19 Pandemic in a Tertiary Healthcare Institution
Abstract
Background: The aims of this paper are to examine the impact of the COVID-19 pandemic on the non-rational use of antibiotics and potential alterations in the antibiotic resistance profiles of multi-drug resistant (MDR) isolates of Klebsiella pneumoniae (KPN), Pseudomonas aeruginosa (PAE), and Acinetobacter baumannii (ABA).
Material and methods: This study was conducted at the tertiary University Hospital "Dr Dragisa Misovic-Dedinje" (Belgrade, Serbia) and was divided into three periods: pre-pandemic (1.4.2019-31.3.2020, period I), COVID-19 pandemic (1.4.2020-31.3.2021, period II), and COVID-19 pandemic-second phase (1.4.2021-31.3.2022, period III). Cultures were taken from each patient with clinically suspected infection (symptoms, biochemical markers of infection). All departments of the hospital were included in this study. Based on the source, all microbiological specimens were divided into 1° blood, 2° respiratory tract (tracheal aspirate, bronchoalveolar lavage fluid, throat, sputum), 3° central-line catheter, 4° urine, 5° urinary catheter, 6° skin and soft tissue, and 6° other (peritoneal fluid, drainage sample, bioptate, bile, incisions, fistulas, and abscesses). After the isolation of bacterial strains from the samples, an antibiotic sensitivity test was performed for each individual isolate with the automated Vitek® 2 COMPACT. Antibiotic consumption testing was performed by the WHO guideline equations (ATC/DDD).
Results: A total of 2196 strains of KPN, PAE, and ABA…
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