Systematic review of time lag between antibiotic use and rise of resistant pathogens among hospitalized adults in Europe

Poku, Edith; Cooper, Katy; Cantrell, Anna; Harnan, S; Sin, Muna Abu; Zanuzdana, Arina; Hoffmann, Alexandra

doi:10.1093/jacamr/dlad001

Cited by 13 publications

(7 citation statements)

References 36 publications

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“…Data obtained across all pathogens (GNB or GPB) showed that the development of antibiotic resistance tends to occur over 0 to 6 months following exposure to antibiotics. 31 Therefore, the data agreed with the rapid changes in antibiotic resistance before and during the COVID-19 pandemic.…”

Section: Discussionsupporting

confidence: 69%

Changes in Antibiotic Resistance Before and During the COVID-19 Pandemic: Retrospective Surveillance Study in a Single Indonesian Tertiary Hospital

Sugianli,

Amelia,

Tjoanatan

et al. 2024

Preprint

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Background: Antibiotic resistance is recognized as a public health threat with significant impacts on mortality and economic burdens. Antibiotic resistance related to inappropriate empiric antibiotics, particularly during the COVID-19 pandemic. However, limited information is available about changes in antibiotic resistance before and during the pandemic in Indonesia. This study aimed to describe changes in the prevalence of antibiotic resistance among patients with proven bacterial infections before and during the COVID-19 pandemic. Methods: A retrospective surveillance study was carried out at a single tertiary hospital to review medical records containing culture and antibiotic susceptibility data among hospitalized patients diagnosed with sepsis and COVID-19 according to the International Classification of Disease (ICD). In this context, the predefined periods were 1 January–31December 2019 and 1 March 2020–31 December 2021. The result was the percentage of resistance to selected antibiotics among the study population, stratified by gram-bacteria type, with the evaluation of changes in antibiotic resistance over time. Results: During the observation period, 596 adult patients were diagnosed with sepsis (before COVID-19), and 2786 were diagnosed with confirmed COVID-19 (during COVID-19). The rate of culture growth in patients with sepsis was greater than that in patients with COVID-19, with values of 51.6% and 29.2%, respectively. Gram-negative bacterial isolates were predominantly found in all observation periods, accounting for 41.2% - 47.3% of the adult middle-aged group. Changes in antibiotic resistance against GNB were observed during COVID-19 (peak phase, above 20%) compared to the early phase. For gram-positive bacteria, the greatestchanges were found in the late phase, reaching 70%. Conclusions: This study revealed that changes in antibiotic resistance before and during the COVID-19 pandemicaffected both GNB and GPB. High antibiotic use and age-related immune responses (i.e., immunosenescence) contributed to these rapid changes. Strengthening strategies, including implementing surveillance systems and antimicrobial stewardship programs and enhancing the capacity of healthcare workers, are recommended for combatting antibiotic resistance.

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Section: Discussionsupporting

confidence: 69%

Changes in Antibiotic Resistance Before and During the COVID-19 Pandemic: Retrospective Surveillance Study in a Single Indonesian Tertiary Hospital

Sugianli,

Amelia,

Tjoanatan

et al. 2024

Preprint

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“…Eliminating the pressure from selected antibiotics such as FQ may not only favor a reduction in MRSA presence but also prompt a rapid decline in resistance. Previ-ous reviews [12,22,[45][46][47] have evaluated the temporal relationship between antibiotic consumption and resistance development in outpatient and primary care settings. Bell et al [12] included 243 studies (case-control, cross-sectional, ecological, and experimental studies) on all antibiotics and bacteria.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Primary Care Antimicrobial Stewardship Program on Meticillin-Resistant Staphylococcus aureus Strains across a Region of Catalunya (Spain) over 5 Years

Jover-Sáenz,

Ramírez-Hidalgo,

Bellés Bellés

et al. 2024

Antibiotics

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Primary care antimicrobial stewardship program (ASP) interventions can reduce the over-prescription of unnecessary antibiotics, but the impact on the reduction in bacterial resistance is less known, and there is a lack of available data. We implemented a prolonged educational counseling ASP in a large regional outpatient setting to assess its feasibility and effectiveness. Over a 5-year post-implementation period, which was compared to a pre-intervention period, a significant reduction in antibiotic prescriptions occurred, particularly those associated with greater harmful effects and resistance selection. There was also a decrease in methicillin-resistant Staphylococcus aureus (MRSA) strains and in their co-resistance to other antibiotics, particularly those with an ecological impact.

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“…Previous systematic reviews show the development of antibiotic resistance mainly occurs between 0 and 6 months after the use of related antibiotics. 37 Second, human factors and equipment contribute to the increase of MDR organisms. The use of Personal Protective Equipment (PPE), which was meant to protect healthcare staff and reduce infection, led to suboptimal utilization and disease transmission.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Kinetics of NLR to Identify Secondary Pulmonary Bacterial Infection Among COVID-19 Patients at Single Tertiary Hospital in Indonesia

Sumardi¹,

Valentino²,

Prasetya³

et al. 2023

IJGM

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Coronavirus disease 2019 (COVID-19) is a new respiratory tract infection caused by severe acute respiratory syndrome coronavirus-2. The presence of secondary pulmonary bacterial infection (SPBI) made COVID-19 difficult to treat. Neutrophillymphocyte count ratio (NLR) is a systemic inflammatory marker used in the diagnosis and prognosis of viral or bacterial infection. At the first 3-5 days after hyperinflammation, it occurs in relation to clinical outcome. Therefore, this study aimed to evaluate the diagnostic value of NLR based on leukocyte kinetics upon admission and after 72 hours among COVID-19 patients with or without SPBI. Patients and Methods: This retrospective cross-sectional study analyzed medical records data of admitted patients with COVID-19 according to the International Classification of Disease 10th Revision (ICD-10) between January and December 2021. The list of patients was extracted and followed by a hand search to identify the inclusion or exclusion criteria and stratified into proven and nonproven SPBI based on clinical data. The study distinguished between SPBI by means of a cut-off value (COV) on the first (D1) and third day (D3), assessed using receiver operating characteristics (ROC), as well as determined the magnitude of sensitivity, specificity, and prevalence ratio. Results: A screening process was conducted on 2902 COVID-19 patients, of which 236 were included, accounting for 8.1%. Among these patients, 87 (36.9%) were found to have proven SPBI. A considerable difference in NLR value between proven and non-proven SPBI was observed on both D1 (11.1 vs 4.2) and D3 (15.3 vs 5.2), with optimal COV of NLR on D1, D3 was found to be 5.29, 9.47, respectively (p < 0.001). Conclusion: NLR on the D1 and D3 distinguished the occurrence of SPBI among COVID-19 patients. The application of NLR assisted in the early determination of bacterial infection and helped in controlling the empirical use of antibiotics.

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Systematic review of time lag between antibiotic use and rise of resistant pathogens among hospitalized adults in Europe

Cited by 13 publications

References 36 publications

Changes in Antibiotic Resistance Before and During the COVID-19 Pandemic: Retrospective Surveillance Study in a Single Indonesian Tertiary Hospital

Changes in Antibiotic Resistance Before and During the COVID-19 Pandemic: Retrospective Surveillance Study in a Single Indonesian Tertiary Hospital

Effects of a Primary Care Antimicrobial Stewardship Program on Meticillin-Resistant Staphylococcus aureus Strains across a Region of Catalunya (Spain) over 5 Years

The Diagnostic Value of Kinetics of NLR to Identify Secondary Pulmonary Bacterial Infection Among COVID-19 Patients at Single Tertiary Hospital in Indonesia

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