Is the Pendulum of Antimicrobial Drug Resistance Swinging Back after COVID-19?

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• The COVID-19 pandemic may have influenced antimicrobial resistance patterns.
• ESKAPE pathogens are a significant cause of hospital-acquired infections.

Purpose of the Study:

• To compare the prevalence of multidrug-resistant (MDR) ESKAPE bacterial infections in COVID-19 positive versus negative patients.
• To analyze MDR rates in intensive care units (ICUs) during the pre-pandemic and pandemic periods.
• To explore the impact of MDR infections on in-hospital mortality.

Main Methods:

• Retrospective analysis of 184 ESKAPE isolates from 561 patients (362 SARS-CoV-2 positive, 199 negative) admitted to ICU or infectious disease units.
• Comparison of MDR rates between COVID-19 and non-COVID-19 patients.
• Analysis of MDR trends in ICUs comparing pre-pandemic and pandemic periods.

Main Results:

• A higher frequency of MDR Gram-negative isolates was observed in COVID-19 patients (74.2%) compared to non-COVID-19 patients (60.3%).
• Acinetobacter baumannii was the predominant pathogen in COVID-19 patients, causing bloodstream infections with a 68.7% mortality rate.
• Increased MDR rates were associated with COVID-19, specifically within the ICU setting.

Conclusions:

• The COVID-19 pandemic appears linked to an increase in MDR ESKAPE infections, particularly in ICUs.
• Acinetobacter baumannii poses a significant threat, associated with increased mortality in COVID-19 patients.
• Urgent implementation of infection control measures is crucial to mitigate the impact of MDR pathogens.