Antibiotic Resistance during COVID-19: A Systematic Review

Abstract

One of the public health issues faced worldwide is antibiotic resistance (AR). During the novel coronavirus (COVID-19) pandemic, AR has increased. Since some studies have stated AR has increased during the COVID-19 pandemic, and others have stated otherwise, this study aimed to explore this impact. Seven databases—PubMed, MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, and CINAHL—were searched using related keywords to identify studies relevant to AR during COVID-19 published from December 2019 to May 2022, according to PRISMA guidelines. Twenty-three studies were included in this review, and the evidence showed that AR has increased during the COVID-19 pandemic. The most commonly reported resistant Gram-negative bacteria was Acinetobacterbaumannii, followed by Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii and K. pneumonia were highly resistant to tested antibiotics compared with E. coli and P. aeruginosa. Moreover, K. pneumonia showed high resistance to colistin. Commonly reported Gram-positive bacteria were Staphylococcus aureus and Enterococcus faecium. The resistance of E. faecium to ampicillin, erythromycin, and Ciprofloxacin was high. Self-antibiotic medication, empirical antibiotic administration, and antibiotics prescribed by general practitioners were the risk factors of high levels of AR during COVID-19. Antibiotics’ prescription should be strictly implemented, relying on the Antimicrobial Stewardship Program (ASP) and guidelines from the World Health Organization (WHO) or Ministry of Health (MOH).

Impact of Adding a Rapid PCR-Based Blood Culture Identification Panel to the Antimicrobial Stewardship Program of Patients with Febrile Neutropenia in a Peruvian Referral Hospital

“…Furthermore, the use of BCID2 panel allowed us to have rapid identification of resistance genes in period 2, highlighting the rise of CPE. This period coincides with the increase of bacterial resistance during the COVID-19 pandemic [ 32 ] and highlights the importance of adjusting the empiric approach for antimicrobial treatment [ 14 , 33 ]. Empirical therapy protocols in our center are based on the initial use of piperacillin/tazobactam or meropenem in a context of high ESBL prevalence.…”

Emerging Antibiotic Resistance in Post-COVID-19 Co-infections

“…Due to a weakened immune system, a person with COVID-19 is more vulnerable to developing a secondary bacterial infection in their lungs. The bacteria associated with COVID-19 pneumonia with bacterial co-infection include Mycoplasma pneumonia, Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa [3][4][5][6]. The most isolated bacteria in COVID-19 patients were Streptococcus pneumoniae while Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus were isolated in those who require hospitalization or ventilator support [2][3][4][5].…”

“…Typical bacteria like Streptococcus pneumonia and Acinetobacter baumannii pneumonia are typically associated with a productive cough and more severe symptoms. Mycoplasma pneumonia is associated with a non-productive cough and milder symptoms [6,8]. Additionally, Mycoplasma pneumonia can often be diagnosed with blood tests or PCR testing for the presence of the bacteria.…”

Secondary multidrug resistant bacterial pneumonia among adult COVID-19 patients: A molecular study

“…The most commonly reported multidrugresistant Gram-negative bacteria (MDR-GN) among COVID-19 patients was Acinetobacter baumannii (A. baumannii), followed by Klebsiella pneumonia (K. pneumonia), Escherichia coli (E. coli), and Pseudomonas aeruginosa (P. aeruginosa) [13]. The majority of secondary coinfections were healthcareassociated infections (HAIs) since they were discovered 48 hours or more after patient's admission [14].…”