Impact of the COVID-19 Pandemic on Antimicrobial Use and Resistance in the United States and the Dominican Republic
Open Forum Infectious Diseases
; 8(SUPPL 1):S305-S306, 2021.
Article
in English
| EMBASE | ID: covidwho-1746586
ABSTRACT
Background. The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. Lower respiratory tract infections (LRTIs) caused by COVID-19 has led to an increase in hospitalizations. Disease severity and concerns for bacterial co-infections can increase antimicrobial pressure. Our aim is to define and compare the impact of COVID-19 on antimicrobial use (AU) and antimicrobial resistance (AMR) in the Dominican Republic (DR) and the United States (US). Methods. We performed a retrospective review of AU and antimicrobial susceptibility patterns from 2019-20 at a hospital in the US (H-US) and the DR (H-DR). Our sites are community teaching hospitals with 151 beds in H-US and 295 beds in H-DR. After AU was tabulated, percent changes between 2019-20 were calculated. Resistance patterns for extended-spectrum beta-lactamase producing (ESBL) E coli, ESBL Klebsiella pneumoniae (ESBL-Kp), carbapenem resistant Pseudomonas aeruginosa (CR-PSAR) and Klebsiella pneumoniae (CR-Kp) were tabulated and percent changes between 2019-20 were calculated. Results. AU increased by 10% in H-US and 25% in H-DR, with carbapenem use increasing by 268% and 144% respectively. Ceftriaxone use increased by 30% in H-US and 33% in H-DR. Azithromycin increased 54% in H-US and 338% in the H-DR. Resistance increased from 10% to 28% for ESBL-Kp and from 10% to 12% for ESBL E coli at H-US. CR-PSAR decreased from 20% to 12%, while cefepime and piperacillin resistance increased from 5% to 20% and 3% to 16% respectively (Figure 1). At H-DR, ESBL-Kp resistance decreased from 68% to 64% and increased from 58% to 59% for ESBL E coli. CR-PSAR and cefepime resistance increased from 5% to 19% and from 9% to 29% respectively (Figure 2). Conclusion. COVID-19 had a major impact on antimicrobial consumption and resistance in the US and DR. A greater impact was seen on ESBL rates in the US whilst a greater impact on carbapenem resistance was seen in the DR. The rise in carbapenem use in H-US reflected a rise in ESBL rates. In the DR, ESBL producing organisms were common prior to COVID-19 and carbapenem use was more widespread. The impact of the COVID-19 pandemic on AU may accelerate AMR worldwide. The scale up of antimicrobial stewardship across the globe is urgently needed to curb AMR.
antiinfective agent; azithromycin; carbapenem; cefepime; ceftriaxone; endogenous compound; extended spectrum beta lactamase; piperacillin; antibiotic resistance; antibiotic sensitivity; antimicrobial stewardship; carbapenem resistance; carbapenem resistant Pseudomonas aeruginosa; coinfection; conference abstract; controlled study; coronavirus disease 2019; Dominican Republic; Escherichia coli; extended spectrum beta lactamase producing Klebsiella pneumoniae; human; nonhuman; pandemic; retrospective study; scale up; teaching hospital; United States
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
Country/Region as subject:
English Caribbean
/
Dominica
/
Dominican Republic
Language:
English
Journal:
Open Forum Infectious Diseases
Year:
2021
Document Type:
Article
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