How were the bacterial distribution, antibacterial resistance, and antibiotic use in our hospital affected by the pandemic?

How Were the Bacterial Distribution, Antibacterial Resistance, and Antibiotic Use in Our Hospital Affected by the Pandemic? Antibacterial resistance and the increase in the number of infections caused by multidrug-resistant bacteria threaten human health worldwide. The COVID-19 pandemic contains factors that can positively or negatively affect antibacterial resistance. This study was conducted to investigate how the COVID-19 pandemic affected bacterial distribution, antibacterial resistance, and antibiotic consumption in our hospital. Our study analyzed the distribution of bacterial growth in blood, urine, and lower respiratory tract cultures of patients hospitalized in Süleyman Demirel University Research and Training Hospital between 01.04.2018 and 31.03.2022. The antibacterial susceptibilities of CoNS, S. aureus, E. faecium, E. faecalis, E. coli, K. pneumoniae, P. aeruginosa, and A. baumannii isolates grown in the cultures were compared between the pre-pandemic and pandemic periods. In addition, consumption of ceftriaxone, meropenem, imipenem, vancomycin, teicoplanin, and levofloxacin before and during the pandemic was evaluated by standardizing according to the daily dose defined per 1000 days of inpatient treatment. The most frequently isolated bacterial species in blood, urine, and lower respiratory tract cultures remained unchanged during the pandemic. In both periods, the most frequently isolated bacterial species were CoNS in blood cultures, E. coli in urine cultures, and A. baumannii in lower respiratory tract cultures. In parallel with ceftriaxone consumption, an increase in the 3rd generation cephalosporin resistance and ESBL rate of E. coli and K. pneumoniae isolates was observed during the pandemic period. In parallel with carbapenem consumption, it was seen that the carbapenem resistance of E. coli and K. pneumoniae isolates increased during the pandemic period, while the carbapenem resistance of A. baumannii isolates decreased. Vancomycin resistance of E. faecium isolates was observed to decrease in parallel with vancomycin consumption. However, despite the increase in teicoplanin consumption, teicoplanin resistance of CoNS and E. faecium isolates decreased. During the pandemic, quinolone resistance increased in S. aureus and K. pneumoniae isolates but decreased in E. faecium and A. baumannii isolates, paralleling quinolone consumption. We concluded that studies that also evaluate patient characteristics should be conducted to support our results in order to understand the true impact of the pandemic on antibacterial resistance and to reach more meaningful results. Keywords: COVID-19, antimicrobial drug resistance, anti-bacterial agents, infections, therapeutic uses