Antimicrobial resistance patterns among critical priority pathogens in an intensive care unit at a tertiary hospital in Egypt: a descriptive analysis comparing pre- and COVID-19 eras

• Published in: Journal of medical microbiology Vol. 73; no. 6
• Main Authors: Zafer, Mai M, Bassiouny, Dina M, Ghosh, Soumya, Bornman, Charné, Hussein, Amira F A
• Format: Journal Article
• Language: English
• Published: England 01-06-2024
• Subjects: Acinetobacter baumannii - drug effects; Adult; Aged; Anti-Bacterial Agents - pharmacology; COVID-19 - epidemiology; Drug Resistance, Bacterial; Egypt - epidemiology; Escherichia coli - drug effects; Escherichia coli - isolation & purification; Female; Humans; Intensive Care Units - statistics & numerical data; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - isolation & purification; Male; Microbial Sensitivity Tests; Middle Aged; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - isolation & purification; Retrospective Studies; SARS-CoV-2 - drug effects; Tertiary Care Centers - statistics & numerical data; Egypt; COVID-19 impact; critical priority pathogens; antimicrobial resistance; Gram-negative infections; intensive care units
• ISSN: 1473-5644
• DOI: 10.1099/jmm.0.001838

The intensified global challenge of antimicrobial resistance, set against the backdrop of the COVID-19 pandemic, is a cause for major concern. Within healthcare settings, intensive care units are recognized as focal points for Gram-negative infections. The study pursued to assess the prevalence and antimicrobial resistance patterns of critical priority pathogens (
,
, Enterobacteriaceae, comprising
and
) during both pre- and COVID-19 periods.
The decision to explore this topic stemmed from the urgent need to understand how the exceptional healthcare crisis of COVID-19 affected AMR patterns.
This was an observational retrospective analysis of 1056 clinical specimens obtained from 950 patients who were admitted to the Medical Intensive Care Unit at Kasr Al-Aini Hospital, Cairo University, Egypt.
In the period before COVID-19, 342 pathogenic isolates (135
.
, 83
.
, 76
.
and 48
) were obtained from samples collected from 450 patients. Conversely, during the COVID-19 period, 714 isolates (237
.
, 205
.
, 199
.
and 73
) were collected from the same number of patients. In the course of the pandemic, there is a slight increase in
and
infections, whereas
and
exhibit a distinct trend with a noticeable reduction in infection rates during COVID-19. During the COVID-19 period, a noticeable rise in resistance rates was observed for all antibiotics utilized. The results from Fisher's exact test indicated a substantial increase in resistance towards certain antibiotics. Specifically, a significant rise in resistance was observed for
to ciprofloxacin (
= 0.00), gentamicin and
(
= 0.02), levofloxacin and
(
= 0.01), piperacillin-tazobactam and
(
= 0.04), and piperacillin-tazobactam and
(
= 0.01).
Our results display how the pandemic impacted bacterial infections and antibiotic resistance, indicating a general increase in resistance rates. These findings are crucial for guiding healthcare practices, emphasizing the need for continued surveillance and potentially checking antibiotic usage schemes.