Antimicrobial resistance in patients with COVID-19: a systematic review and meta-analysis

Langford, Bradley J; So, Miranda; Simeonova, Marina; Leung, Valerie; Lo, Jennifer; Kan, Tiffany; Raybardhan, Sumit; Sapin, Mia; Mponponsuo, Kwadwo; Farrell, Ashley; Leung, Elizabeth; Soucy, Jean‐Paul; Cassini, Alessandro; MacFadden, Derek R.; Daneman, Nick; Bertagnolio, Silvia

doi:10.1016/s2666-5247(22)00355-x

Cited by 63 publications

(38 citation statements)

References 164 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, our study is the first to show a causal effect of gut microbiota alterations in post-COVID sequalae. Our findings confirm previous data that SARS-CoV-2 infection is associated with spread of antimicrobial resistance in gut microbiota (Bernard-Raichon et al, 2022;de Nies et al, 2023;Kariyawasam et al, 2022;Langford et al, 2022aLangford et al, , 2022bLópez-Jácome et al, 2022). In fact, we observed the increase of AMR Enterobacteriaceae in the gut microbiota of post-COVID individuals who were either asymptomatic or had mild symptoms of COVID-19.…”

Section: Discussionsupporting

confidence: 92%

Gut microbiota from patients with COVID-19 cause alterations in mice that resemble post-COVID symptoms

Almeida

Engel

Ricci

et al. 2023

Preprint

View full text Add to dashboard Cite

Long-term sequelae after Coronavirus disease (COVID)-19 are frequent and of major concern. SARS-CoV-2 infection affects the host's gut microbiota, which is linked with disease severity in patients with COVID-19. We report here that the gut microbiota of post-COVID subjects had a remarkable predominance of Enterobacteriaceae strains with antibiotic-resistance phenotype compared to healthy controls. Additionally, short-chain fatty acids (SCFA) levels were reduced in their feces. Fecal transplant from post-COVID subjects to germ-free mice led to lung inflammation and worst outcomes during pulmonary infection by multidrug-resistant Klebsiella pneumoniae. Transplanted mice also had poorer cognitive performance. Overall, we show prolonged impacts of SARS-CoV-2 infection in the gut microbiota that persist after subjects have cleared the virus. Together, these data demonstrate that the gut microbiota can directly contribute to post-COVID sequelae, suggesting that it may be a potential therapeutic target.

show abstract

Section: Discussionsupporting

confidence: 92%

Gut microbiota from patients with COVID-19 cause alterations in mice that resemble post-COVID symptoms

Almeida

Engel

Ricci

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The observed signi cant impact of COVID-19 on antimicrobial prescription practices, is demonstrable in both short-term and long-lasting over-prescription of these drugs. These ndings are in keeping with previous reports which highlighted the potential short-and long-term effects of the pandemic on antimicrobial utilization and emergence of resistance [32][33][34][35]. Factors such as the heightened use of empiric antibiotics for COVID-19 patients, higher prescription rates of antibiotics for telemedicine consultations and adverse effect on the implementation of antibiotic stewardship programs have been identi ed [32,33].…”

Section: Discussionsupporting

confidence: 88%

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

Senok

AlDabal

Khansaheb³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Antimicrobial Resistance (AMR) presents a pressing public health challenge globally which has been compounded by the COVID-19 pandemic. Elucidation of the impact of the pandemic on AMR evolution using population-level data that integrates clinical, laboratory and prescription data remains lacking. Methods: Data was extracted from the centralized electronic platform which captures the health records of 60,551 patients across the network of public healthcare facilities in Dubai, United Arab Emirates. For all inpatients and outpatients diagnosed with bacterial infection between 01/01/2017 and 31/05/2022, structured and unstructured Electronic Health Record data, microbiological laboratory data including antibiogram, molecular typing and COVID-19 testing information as well as antibiotic prescribing data were extracted curated and linked. Various analytical methods, including time-series analysis, natural language processing (NLP) and unsupervised clustering algorithms, were employed to investigate the trends of antimicrobial usage and resistance over time, assess the impact of prescription practices on resistance rates, and explore the effects of COVID-19 on antimicrobial usage and resistance. Results: Our findings identified a significant impact of COVID-19 on antimicrobial prescription practices, with short-term and long-lasting over-prescription of these drugs. Resistance to antimicrobials increased the odds ratio of mortality to an average of 2.5 and the effects of prescription practices on resistance were observed within one week of initiation. Significant trends in antimicrobial resistance, exhibiting fluctuations for various drugs and organisms, with an overall increasing trend in resistance levels, particularly post-COVI D-19 were identified. Conclusion: This study provides a population-level insight into the evolution of AMR in the context of COVID-19 pandemic. The findings emphasize the long-term effect of COVID-19 on the AMR crisis and the critical need for improved antimicrobial stewardship to tackle AMR evolution.

show abstract

“…21 The authors of this systematic review highlighted the urgent need for more research and surveillance to evaluate the effect of COVID-19 on AMR at the patient and population level. 21 It is important to note that in another recent systematic review and meta-analysis that assessed antibiotic use during the COVID-19 pandemic, the authors showed that antimicrobial use occurred in 68% (95% CI 60-75%) of COVID-19 patients. 20 Concerns regarding secondary bacterial infections in COVID-19 patients may explain the more widespread use of various broad-What is already known about this subject…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of bacterial co‐infection was 5.3% (95% confidence interval [CI] 3.8‐7.4), the prevalence of secondary bacterial infection was 18.4% (14.0‐23.7), and the proportion of infections that were resistant to antimicrobials was 60.8% (95% CI 38.6‐79.3) 21 . The authors of this systematic review highlighted the urgent need for more research and surveillance to evaluate the effect of COVID‐19 on AMR at the patient and population level 21 . It is important to note that in another recent systematic review and meta‐analysis that assessed antibiotic use during the COVID‐19 pandemic, the authors showed that antimicrobial use occurred in 68% (95% CI 60‐75%) of COVID‐19 patients 20 …”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID‐19 pandemic on antibiotic consumption and prevalence of pathogens in primary and secondary healthcare settings in Northern Ireland

Aldeyab

Crowe

Karasneh

et al. 2023

Brit J Clinical Pharma

View full text Add to dashboard Cite

AimTo evaluate the impact of the COVID‐19 pandemic on the patterns of antimicrobial use and the incidence of pathogens in primary and secondary healthcare settings in Northern Ireland.MethodsData were collected on antibiotic use and Gram‐positive and Gram‐negative pathogens from primary and secondary healthcare settings in Northern Ireland for the period before (January 2015‐March 2020) and during (April 2020‐December 2021) the pandemic. Time series intervention analysis methods were utilized.ResultsIn the hospital setting, the mean total hospital antibiotic consumption during the pandemic was 1864.5 defined daily doses (DDDs) per 1000 occupied‐bed days (OBD), showing no significant change from pre‐pandemic (P = .7365). During the pandemic, the use of second‐generation cephalosporins, third‐generation cephalosporins, co‐amoxiclav and levofloxacin increased, there was a decrease in the percentage use of the hospital Access group (P = .0083) and an increase in the percentage use of Watch group (P = .0040), and the number of hospital Klebsiella oxytoca and methicillin‐susceptible Staphylococcus aureus cases increased. In primary care, the mean total antibiotic consumption during the COVID‐19 pandemic was 20.53 DDDs per 1000 inhabitants per day (DID), compared to 25.56 DID before the COVID‐19 pandemic (P = .0071). During the pandemic, there was a decrease in the use of several antibiotic classes, an increase in the percentage use of the Reserve group (P = .0032) and an increase in the number of community‐onset Pseudomonas aeruginosa cases.ConclusionThis study provides details of both changes in antibiotic consumption and the prevalence of infections in hospitals and primary care before and during the COVID‐19 pandemic that emphasize the importance of antimicrobial stewardship in pandemic situations.

show abstract

Antimicrobial resistance in patients with COVID-19: a systematic review and meta-analysis

Cited by 63 publications

References 164 publications

Gut microbiota from patients with COVID-19 cause alterations in mice that resemble post-COVID symptoms

Gut microbiota from patients with COVID-19 cause alterations in mice that resemble post-COVID symptoms

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

The impact of the COVID‐19 pandemic on antibiotic consumption and prevalence of pathogens in primary and secondary healthcare settings in Northern Ireland

Contact Info

Product

Resources

About