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Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network
Luis Esaú López-Jácome1, Diana Fernández-Rodríguez1, Rafael Franco-Cendejas1
1División de Infectología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra," Ciudad de México, Mexico.
Abstract:
This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic in Mexico. We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic). In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (p ≤ 0.01) was detected for Staphylococcus aureus, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (p ≤ 0.01), for Klebsiella pneumoniae. In all specimens, increased ampicillin and tetracycline resistance was detected for Enterococcus faecium (p ≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Escherichia coli; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Pseudomonas aeruginosa. Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for S. aureus and carbapenem resistance for K. pneumoniae recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in S. aureus was detected, which may be associated with high azithromycin use. In general, for Acinetobacter baumannii and P. aeruginosa, increasing resistance rates were detected.
Insights
Antimicrobial resistance in critical pathogens significantly increased in Mexico during the COVID-19 pandemic. This rise was observed in Staphylococcus aureus, Klebsiella pneumoniae, and other key bacteria, highlighting urgent public health concerns.
Area of Science:
- Microbiology and Infectious Diseases
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic has raised concerns about its impact on antimicrobial resistance (AMR) patterns.
- Understanding AMR trends is crucial for effective infection control and treatment strategies, especially for critical pathogens.
Purpose of the Study:
- To evaluate changes in antimicrobial resistance among critical and high-priority microorganisms in Mexico.
- To compare AMR data from pre-pandemic (2019) and pandemic (2020) periods, specifically focusing on the second semester.
Main Methods:
- Collection and analysis of antimicrobial susceptibility data for critical and high-priority microorganisms from various sample types (blood, urine, respiratory).
- Stratification and comparison of data between two periods: 2019 vs. 2020, and second semester 2019 vs. second semester 2020.
- Statistical analysis to determine significant changes in resistance rates.
Main Results:
- Significant increases in antimicrobial resistance were observed during the COVID-19 pandemic.
- Notable increases include oxacillin resistance in Staphylococcus aureus (15.2% to 36.9%) and carbapenem resistance (imipenem, meropenem) in Klebsiella pneumoniae (13% to 23.4%, 11.2% to 21.4%) from blood samples.
- Increased resistance rates were also detected for Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa against various antibiotics.
Conclusions:
- Antimicrobial resistance has demonstrably increased in Mexico during the COVID-19 pandemic.
- The rise in resistance for S. aureus and K. pneumoniae from blood warrants particular attention.
- Observed increases in resistance, such as erythromycin resistance in S. aureus potentially linked to azithromycin use, highlight the need for antimicrobial stewardship.
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