Antimicrobial resistance and antimicrobial therapy modification during COVID19 pandemic in large tertiary hospital

Abstract

Objective. assessment of the evolution of the microbiological landscape of the hospital for the period of operation in 2020 into a pandemic of a new coronavirus infection in various departments, including intensive care units; change depending on the results of antibacterial therapy regimens. Materials and Methods. In a retrospective study, conducted from June to December 2020, in a multidisciplinary hospital working with COVID-19 infection, the resistance of isolated strains of microorganisms was analyzed in patients of different age groups. Resistance was assessed with test points in June and November 2020; depending on this, proposals were made to correct the internal (local) protocols of antimicrobial therapy. Results. The need for frequent and regular microbiological monitoring was confirmed. Further, we understood that the territories of the main and temporary hospital of the City Clinical Hospital No. 40 are heterogeneous and there are obvious differences both in structure and in the level of sensitivity. “In practice, these are two different hospitals”. Within the territories, the branches also differ from each other. When analyzing resistance in ICUs, it was revealed that within each hospital in each department, albeit similar in structure and profile of patients, there is a different level of resistance of strains. Conclusions. The structure of sensitivity generally corresponds to the world data, but for some pathogens it differs significantly. Microbiological monitoring should be carried out not only inside the hospital, but also inside the department. The increase in consumption of carbapenems and protected cephalosporins requires a reassessment of the practice of using AMP in any covid hospital, due to the impact on the epidemic situation both in the ICUs and in the hospital.

The significance of monitoring respiratory sample cultures and polymerase chain reaction tests for detecting bacterial pathogens in severely and critically ill patients with COVID-19

“…This trend is confirmed by the results of other Russian and international studies. [19][20][21] For instance, in a study by Maes et al, [19] no significant differences in bacterial pathogens were found between patients with ventilator-associated pneumonia with and without COVID-19. However, the COVID-19 group had a significantly higher risk of developing ventilator-associated pneumonia, as well as isolated cases of invasive aspergillosis.…”

Point prevalence multicenter survey of antimicrobial consumption in Russian hospitals: results of the Global-PPS 2021

“…Хотя устойчивость микроорганизмов к АМП на се годняшний день не является новой проблемой, распро странение резистентных микроорганизмов представляет собой одну из ведущих угроз здравоохранению во всем мире [1,2]. Особенно настораживает ситуация с рас пространением устойчивых нозокомиальных штаммов, которые зачастую вызывают тяжелые бактериальные инфекции, заканчивающиеся летальным исходом [14].…”

Antimicrobial Prescribing Patterns in Patients with COVID-19 in Russian Multi-Field Hospitals in 2021: Results of the Global-PPS Project

“…Emergent antibiotic resistance following the global response to COVID-19 has already been described as “the silent pandemic” [ 2 ], which emphasizes the importance of prudent use of AMD in this group of patients. The preliminary data on COVID-19 influence on epidemiology of nosocomial infections and antimicrobial resistance in Russian hospitals were diverse and inconclusive [ 21 ], but a study performed in a hematological center in Kazakhstan showed a prominent increase in the prevalence of resistant nosocomial isolates; the share of Pseudomonas aeruginosa carbapenemase-producing strains increased from 0% in the pre-pandemic period to 30.4%; the share of methicillin-resistant Staphylococcus aureus increased from 11.8% to 35%, respectively [ 22 ]. The selection of resistance to antibiotics combined with the lack of perspectives for the introduction of new drugs in clinical practice in the near future highlights the urgent need to reassess the practice of AMD prescribing.…”