Antibiotic resistance and consumption before and during the COVID-19 pandemic in Valle del Cauca, Colombia.

Objective: To assess changes in antibiotic resistance of eight of the World Health Organization priority bug-drug combinations and consumption of six antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, ciprofloxacin, vancomycin) before (March 2018 to July 2019) and during (March 2020 to July 2021) the COVID-19 pandemic in 31 hospitals in Valle del Cauca, Colombia. Methods: This was a before/after study using routinely collected data. For antibiotic consumption, daily defined doses (DDD) per 100 bed-days were compared. Results: There were 23 405 priority bacterial isolates with data on antibiotic resistance. The total number of isolates increased from 9 774 to 13 631 in the periods before and during the pandemic, respectively. While resistance significantly decreased for four selected bug-drug combinations (Klebsiella pneumoniae, extended spectrum beta lactamase [ESBL]-producing, 32% to 24%; K. pneumoniae, carbapenem-resistant, 4% to 2%; Pseudomonas aeruginosa, carbapenem-resistant, 12% to 8%; Acinetobacter baumannii, carbapenem-resistant, 23% to 9%), the level of resistance for Enterococcus faecium to vancomycin significantly increased (42% to 57%). There was no change in resistance for the remaining three combinations (Staphylococcus aureus, methicillin-resistant; Escherichia coli, ESBL-producing; E. coli, carbapenem-resistant). Consumption of all antibiotics increased. However, meropenem consumption decreased in intensive care unit settings (8.2 to 7.1 DDD per 100 bed-days). Conclusions: While the consumption of antibiotics increased, a decrease in antibiotic resistance of four bug-drug combinations was observed during the pandemic. This was possibly due to an increase in community-acquired infections. Increasing resistance of E. faecium to vancomycin must be monitored. The findings of this study are essential to inform stewardship programs in hospital settings of Colombia and similar contexts elsewhere.

Resistance of SARS-CoV-2 Variants to Monoclonal Antibodies

The article discusses that the researchers examined the susceptibility of two Omicron BA.4.6 isolates to available antiviral drugs and monoclonal antibodies. The results indicate that prevalent SARS-CoV-2 variants are increasingly resistant to therapeutic and prophylactic monoclonal antibodies but remain susceptible to Paxlovid, remdesivir, and molnupiravir.

Detection Of the Most Important Bacteria Accompanying Covid-19 Patients, with Measurement of Some Immube Indicators in Infected and Vaccinated Patients

Our study was conducted on (COVID19) patients lying in the isolation wards of Al-Sharqat-General-Hospital and Salah-AI-Din-Military-Hospital, for the period from mid-October 2021 AD to March 2022AD, for ages (25-75years) and for both sexes. Collected 70-samples of throat swab, to detect secondary bacterial infection associated with COVID19, it was found that 66(94.28%) samples are growth-positive, and 4 (5.71%) samples are growth-negative. The isolates were distributed into 48 isolates (72.72%) belonging to Gram-positive bacteria, 18 isolates (27.27%) belonging to Gram-negative bacteria, and the number of pure single isolates reached 66 isolate. (24) isolates of Staphylococcus aureus with a percentage of 36.36% are the most prevalent bacteria among positive bacteria isolates. The rate of secondary bacterial infection among those infected with COVID-19 has been shown to be caused by Staph. aureus, which causes various respiratory infections, and (14) isolates of Streptococcus Pneumonia by 21.21% and it is among the bacterial causes associated with secondary infection, that these bacteria naturally inhabit the respiratory passages, but they can enter the lungs by inhalation, where it was found to be one of the most common causes of respiratory tract infection and (10) Streptococcus pyogens isolate in 15.15% is an associated bacterial cause with secondary infection. She indicated that the bacterium Strep, pyognes possess several virulence factors that help them spread by breaking down connective tissue. During the 1918 influenza outbreak, Pfeiffer discovered Strep, pyogenes as a prominent bacterial organism in influenza, as for the number of Gram-negative bacterial isolates, (14) isolates of Klebsiella pneumoniae amounted to 21.21% and it is the most Gram-negative bacterial species associated with secondary infection and antibiotic resistance with what It was reached (Ahmed et al, 2021) and in a percentage (40.5%), where these bacteria are transient natural flora present on the body, as it is considered an opportunistic infection in patients and hospitals, and (4) an isolate belonging to Moraxella catarrhalis with a percentage of 6.06%. The results showed the extent of resistance of some commonly used antibiotics against isolated bacteria, where Staphylococcus aureus was resistant to Azithromycin 100%, while Streptococcus pyogenes was more resistant to antibiotics with 100% to amoxicillin/clavulanic acid, levofloxacin, ceftriaxone, and amikacin. Pneumococci were 100% resistant to ceftriaxone, and as for Gram-negative bacteria, the results showed that they were resistant to most of the antibiotics used in the current study.

Evolving with new threats

Kate Scheer discusses how infectious dieseases influence infection control in dentistry.