Distribution and antibiotic resistance of Gram-negative bacteria from blood cultures before and during the COVID-19 pandemic
Abstract
INTRODUCTION: Antimicrobial resistance in bloodstream infections is an important clinical challenge. The impact of the coronavirus disease 2019 (COVID-19) pandemic on antimicrobial resistance remains a subject of ongoing debate. This single-center study aimed to analyze Gram-negative bacteria (GNB) isolated from blood cultures and evaluate changes in antimicrobial resistance between the pre-pandemic (March 2018-February 2020) and pandemic (March 2020-February 2022) periods.
METHODOLOGY: Blood culture data collected over 4 years were retrospectively analyzed using the BACT/ALERT 3D system. Bacterial identification was conducted with the VITEK® 2 compact system, and antimicrobial susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria.
RESULTS: Of 1,668 positive blood cultures, 38.3% yielded GNB. There was an increase in Gram-negative isolates during the pandemic, compared to the pre-pandemic period (55.9% vs. 44.1%). Resistance changes were detected in extensive antibiogram analyses in which 18 different antibiotics were studied for the 4 most frequently isolated species, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. During the pandemic period, resistance to amoxicillin/clavulanic acid, ampicillin, ampicillin-sulbactam, ceftriaxone, and cefuroxime decreased; while resistance to amikacin, levofloxacin, and cefepime increased; except in Escherichia coli.…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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