Antimicrobial resistance before and after the COVID-19 pandemic in Northern Brazil

巴西北部地区在新冠疫情前后抗菌素耐药性的变化

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Abstract

OBJECTIVE: This study evaluates the impact of the COVID-19 pandemic on the profile of bacterial resistance in healthcare-associated lower respiratory tract infections (HAI/LRTI), in an intensive care unit. SETTING: City of Belém-PA. DESIGN: This is a retrospective and analytical cross-sectional study, in which the resistance profile of HAI/LRTI bacterial isolates was evaluated over 2018-2022. RESULTS: The review of HAI notifications revealed 330 lower respiratory tract infections during the study period. The bacteria with a significant change in the resistance profile between the period pre-COVID and the post-COVID periods were P. aeruginosa (P = .011), K. pneumoniae (P < .001) and A. baumannii (P = .001), with increased profiles multidrug-resistant, and extensively drug-resistant, and strains with pandrug-resistant profile, in 2020 and 2021. In the analysis by antibiotic class, there was a significant increase in A. baumannii resistance to carbapenems and K. pneumoniae resistance to carbapenems. CONCLUSIONS: Comparing the periods, there was an emergence of K. pneumoniae resistant to aminoglycosides and carbapenems; of P. aeruginosa with tendency to resistance to aminoglycoside, carbapenem, 4th generation cephalosporin and anti-pseudomonal penicillin + beta-lactamase inhibitor; of A. baumannii resistant to aminoglycoside, carbapenem, quinolone, anti-pseudomonal penicillin + beta-lactamase inhibitor and penicillin + beta-lactamase inhibitor and 4th generation cephalosporin.

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