Trend analysis of carbapenem-resistant Gram-negative bacteria and antimicrobial consumption in the post-COVID-19 era: an extra challenge for healthcare institutions

J Hosp Infect. 2022 Feb:120:43-47. doi: 10.1016/j.jhin.2021.11.011. Epub 2021 Nov 19.

Abstract

The incidence density trend of the carbapenem-resistant Gram-negative bacteria was analysed in device-associated infections and antimicrobial consumption in 99 critical care facilities in a low/middle-income country, between January 2019 and December 2020. Carbapenem-resistant Acinetobacter baumannii (CRAB) per 1000 patient-days increased in 2020 and this finding had a strong positive correlation with the incidence density of COVID-19 by the Spearman test. Polymyxin consumption also increased in 2020 but without significant correlation with CRAB or COVID-19 incidence density, presumably due to empirical and untargeted prescribing as a consequence of concern about CRAB infections. These findings are a warning to infection control programmes and antimicrobial stewardship.

Keywords: Acinetobacter baumannii; Antimicrobial drug resistance; COVID-19; Carbapenems; Healthcare-associated infections; Polymyxins.

MeSH terms

  • Acinetobacter baumannii*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents*
  • COVID-19*
  • Carbapenems
  • Delivery of Health Care
  • Drug Resistance, Bacterial
  • Gram-Negative Bacteria
  • Humans
  • Microbial Sensitivity Tests
  • SARS-CoV-2

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Carbapenems