Abstract
Background
The increasing incidence of antibiotic resistance was a major health problem before the Corona Virus Disease 2019 (COVID-19) pandemic, but in the post-COVID era this problem has worsened. The purpose of this study is to describe and analyze the incidence of multidrug-resistant pathogens in an intensive care unit before (2019), and at the end of the COVID-19 pandemic (2022).
Methods
This is a retrospective, single-center, observational cohort study of infections in patients admitted to the Intensive Care Unit (ICU) of the Sf. Spiridon County Emergency Hospital (Iasi, Romania) during two distinct periods - before and after the first three waves of the COVID-19 pandemic. Species distribution and resistance profile of clinical isolates were recorded.
Results
Among the isolated pathogens, the Gram-negative bacteria strains accounted for the majority of microorganisms in both years (77.81% in 2019 and 71.01% in 2022) with the Acinetobacter baumannii isolates being the most abundant in 2019 (87 strains, 32.22%), and Klebsiella pneumoniae in 2022 (107 strains, 40.07%). When considering the overall profile of resistance rates, significant post-pandemic increases were observed for the following antimicrobial agents: tobramycin, ceftazidime, ertapenem, colistin, piperacillin/tazobactam and also for the recently introduced antibiotics in Europe - ceftolozane-tazobactam, ceftazidime-avibactam, imipenem-relebactam.
Conclusions
We have noticed the emergence of new multidrug resistant strains in the ICU. In ICUs, the increase in antibiotic resistance following the COVID-19 pandemic is a multifaceted issue driven by the interplay of clinical practices, healthcare system disruptions, and infection control challenges. It was fueled by several factors like overuse and misuse of antibiotics, extended hospital stays, and inadequate infection control.