The Effect of the COVID-19 Pandemic on Urine Culture Results and Resistance to Antibiotics in the Emergency Department.

ABSTRACT

BACKGROUND: This study aimed to investigate the effect of the COVID-19 pandemic on urine culture results and antibiotic sensitivities in patients with suspected urinary tract infections (UTI) admitted to the emergency department (ED) and determine more accurate treatment modalities for patients. The primary endpoint of our study was to determine the change in antibiotic resistance of UTI agents in the pre-and post-COVID period. METHODS: In the study, urine samples were sent from ED to the microbiology laboratory with a preliminary diagnosis of UTI between June 1, 2019, and July 1, 2021. Urine samples with the growth of 105 cfu/mL and above in urine cultures or with the growth of 103 cfu/mL and above in urine sample cultures taken from catheters were examined. At the end of the exclusions, the results of a total of 1,090 patients were evaluated. Urine cultures and an-tibiotic susceptibility tests of the patients included in the study were examined in two periods (pre-pandemic and post-pandemic). RESULTS: A total of 1,090 aerobic urine cultures sent from the ED between June 2019 and June 2021 were finalized in the microbiology laboratory. Of the 1,090 urine cultures sent from the ED within the 24 months included in the study, 497 (45.59%) were sent eight months before the COVID-19 pandemic. Growth was detected in 33 (6.63%) cultures. In the 16 months after the pandemic, 593 (54.41%) urine cultures were sent. Growth was seen in 69 (11.6%) cultures. The positivity rate obtained from urine cultures sent after the COVID-19 pandemic was significantly higher than those sent before the COVID-19 pandemic (p = 0.005). According to cultures and antibiogram results, resistance to ampicillin, cefuroxime, cefuroxime axetil, cefoxitin, cefixime, ceftazidime, ceftriaxone, and amoxicillin-clavulanic acid decreased significantly compared with pre-COVID-19 (p < 0.05). In addition, Extended Spectrum Beta-Lactamase (ESBL) resistance decreased significantly compared with the prepandemic period (p = 0.012). CONCLUSIONS: In this study, we found that the susceptible to antibiotics increased significantly in the post-COVID-19 period compared to the pre-COVID-19 period.