Correlation between Acinetobacter baumannii Resistance and Hospital Use of Meropenem, Cefepime, and Ciprofloxacin: Time Series Analysis and Dynamic Regression Models

Kousovista, Rania; Athanasiou, Christos; Liaskonis, Konstantinos; Ivopoulou, Olga; Ismailos, George; Karalis, Vangelis

doi:10.3390/pathogens10040480

Cited by 9 publications

(17 citation statements)

References 37 publications

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“…Serbia's national guideline for COVID-19 treatment (provided in Supplementary Table S3) emphasizes the absolute avoidance of antibiotic use precisely because of the risk of rising AMR. Moreover, in-hospital use of antibiotics has known to be a driver of resistance in a time-dependent manner [39], pointing to a need for rational use of antimicrobials across all levels of care.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

et al. 2021

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Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

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Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

et al. 2021

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“…The majority of the articles 13 (22.3%) were published in China [ 21 , 25 – 28 , 42 , 60 , 62 – 64 , 68 , 72 , 77 ], 4 (6.9%) Europe [ 48 , 49 , 74 , 75 ], 4 (6.9%) South Korea [ 31 , 54 , 61 , 65 ], 4 (6.9%) Serbia [ 34 , 36 , 39 , 52 ], 3 (5.2%) Japan [ 20 , 30 , 40 ], 2 (3.4%) Italy [ 22 , 33 ], 2 (3.4%) Thailand [ 35 , 57 ], 2 (3.4%) France [ 46 , 56 ], 2 (3.4%) Spain [ 43 , 59 ], 2 (3.4%) Slovenia [ 47 , 71 ], 2 (3.4%) Switzerland [ 45 , 70 ], and the rest were in different countries [ 23 , 29 , 32 , 37 , 38 , 41 , 44 , 50 , 51 , 53 , 55 , 58 , 66 , 67 , 69 , 73 , 76 , 77 ]. The majority of the articles 11(23.4%) were published in 2017 [ 22 , 33 , 36 , 44 , 47 , 48 , 52 , 56 , 59 , 64 , 67 ], 2018 […”

Section: Resultsmentioning

confidence: 99%

Relationship between Antibiotic Consumption and Resistance: A Systematic Review

Abejew,

Wubetu,

Fenta

2024

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Unreserved use of antibiotics exerted selective pressure on susceptible bacteria, resulting in the survival of resistant strains. Despite this, the relationship between antibiotic resistance (ABR) and antibiotic consumption (ABC) is rarely studied. This systematic review aims to review the relationship between ABC and ABR from 2016 to 2022. Methods. Articles published over 7 years (2016–2022) were searched from December 23 to 31, 2022. The search strategy was developed by using keywords for ABC and ABR. From 3367 articles, 58 eligible articles were included in the final review. Results. The pooled ABC was 948017.9 DPDs and 4108.6 DIDs where over 70% of antibiotics were from the Watch and Reserve category based on the WHO AWaRe classification. The average pooled prevalence of ABR was 38.4%. Enterococcus faecium (59.4%), A. baumannii (52.6%), and P. aeruginosa (48.6%) were the most common antibiotic-resistant bacteria. Cephalosporins (76.8%), penicillin (58.3%), and aminoglycosides (52%) were commonly involved antibiotics in ABR. The positive correlation between ABR and consumption accounted for 311 (81%). The correlation between ABR P. aeruginosa and ABC accounted for 87 (22.7%), followed by 78 (20.3%) and 77 (20.1%) for ABR E. coli and K. pneumoniae with ABCs, respectively. Consumption of carbapenems and fluoroquinolones was most commonly correlated with resistance rates of P. aeruginosa, K. pneumoniae, E. coli, and A. baumannii. Conclusion. There is a positive correlation between ABC and the rate of ABR. The review also revealed a cross-resistance between the consumption of different antibiotics and ABR. Optimizing antibiotic therapy and reducing unnecessary ABC will prevent the emergence and spread of ABR. Thus, advocating the implementation of stewardship programs plays a pivotal role in containing ABR.

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“…Such observation indicates the significant shift of resistance profiles with COVID-19, and may be attributed to the inability to completely conform with standard practices of infection control during such unprecedented time ( Pascale et al., 2021 ). Also, the in-hospital use of antibiotics has known to be a driver of resistance in a time-dependent manner whether or not a pandemic takes place, highlighting the need for rational antimicrobial use across all levels of healthcare ( Kousovista et al., 2021 ), and this indeed, applies to carbapenems. In one retrospective single-center, case-control study, authors from Spain reported that COVID-19 patients had increased risk of nosocomial infections with carbapenemase-producing Enterobacteriaceae , with infections being severe, appearing in critically-ill patients, and associated with a high mortality.…”

Section: Carbapenemase-producers Causing Co-infections In Covid-19 Pa...mentioning

confidence: 99%

The Collateral Effects of COVID-19 Pandemic on the Status of Carbapenemase-Producing Pathogens

Moubareck

Halat

2022

Front. Cell. Infect. Microbiol.

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The serious challenge of antimicrobial resistance continues to threaten public health and lingers in the era of the coronavirus disease 2019 (COVID-19), declared pandemic by the World Health Organization. While the pandemic has triggered the importance of infection control practices and preventive measures such as physical distancing, hand hygiene, travel reduction and quarantine, the ongoing alarm of antimicrobial resistance seems to accompany the pandemic too. Antimicrobial resistance has been fostered during COVID-19, possibly due to high rate of empirical antibiotic utilization in COVID-19 patients, increased use of biocides, and the disruption of proper healthcare for other conditions. Specifically, carbapenemase-producing Gram-negative bacteria have shown to cause secondary bacterial infections in patients hospitalized for COVID-19. Clinical and microbiological evidence of such infections is accumulating in different parts of the world. With the resilient nature of carbapenemases, their association with mortality, and the limited treatment options available, concerns regarding this group of antibiotic-hydrolyzing enzymes during the pandemic are expected to upsurge. While the additional burden carbapenemases exert on healthcare is worrisome, it remains hidden or abandoned among the various health consequences of the pandemic. The purpose of this minireview is to shed a light on carbapenemase-associated infections during such unprecedented time of COVID-19. A focused insight shall be made into carbapenemases, their implications for COVID-19 patients, and the features and consequences of co-infection, with a review of available evidence from pertinent literature. The importance of increased surveillance for carbapenemase-producers and optimizing their management in relation to the pandemic, shall be addressed as well.

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Correlation between Acinetobacter baumannii Resistance and Hospital Use of Meropenem, Cefepime, and Ciprofloxacin: Time Series Analysis and Dynamic Regression Models

Cited by 9 publications

References 37 publications

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Relationship between Antibiotic Consumption and Resistance: A Systematic Review

The Collateral Effects of COVID-19 Pandemic on the Status of Carbapenemase-Producing Pathogens

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