Cropping Up Crisis at the Nexus Between COVID-19 and Antimicrobial Resistance (AMR) in Africa: A Scoping Review and Synthesis of Early Evidence

Gutema, Girma; Homa, Gadissa

doi:10.7759/cureus.21035

Cited by 3 publications

(1 citation statement)

References 59 publications

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“…COVID-19 spread rapidly and extensively to Africa [ 175 , 176 ]. In Africa, as in other LMICs, bacterial resistance is strongly correlated with poor governance and transparency more than with factors such as antibiotic use.…”

Section: State Of the Art In The Worldmentioning

confidence: 99%

Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic

Catalano,

Iacopetta,

Ceramella

et al. 2023

Viruses

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Antibacterial resistance is a renewed public health plague in modern times, and the COVID-19 pandemic has rekindled this problem. Changes in antibiotic prescribing behavior, misinformation, financial hardship, environmental impact, and governance gaps have generally enhanced the misuse and improper access to antibiotics during the COVID-19 pandemic. These determinants, intersected with antibacterial resistance in the current pandemic, may amplify the potential for a future antibacterial resistance pandemic. The occurrence of infections with multidrug-resistant (MDR), extensively drug-resistant (XDR), difficult-to-treat drug-resistant (DTR), carbapenem-resistant (CR), and pan-drug-resistant (PDR) bacteria is still increasing. The aim of this review is to highlight the state of the art of antibacterial resistance worldwide, focusing on the most important pathogens, namely Enterobacterales, Acinetobacter baumannii, and Klebsiella pneumoniae, and their resistance to the most common antibiotics.

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Section: State Of the Art In The Worldmentioning

confidence: 99%

Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic

Catalano,

Iacopetta,

Ceramella

et al. 2023

Viruses

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A pandemic within a pandemic? Admission to COVID-19 wards in hospitals is associated with increased prevalence of antimicrobial resistance in two African settings

Elton

Hamid

Tembo

et al. 2023

Ann Clin Microbiol Antimicrob

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Background Patients who develop severe illness due to COVID-19 are more likely to be admitted to hospital and acquire bacterial co-infections, therefore the WHO recommends empiric treatment with antibiotics. Few reports have addressed the impact of COVID-19 management on emergence of nosocomial antimicrobial resistance (AMR) in resource constrained settings. This study aimed to ascertain whether being admitted to a COVID-19 ward (with COVID-19 infection) compared to a non-COVID-19 ward (as a COVID-19 negative patient) was associated with a change in the prevalence of bacterial hospital acquired infection (HAI) species or resistance patterns, and whether there were differences in antimicrobial stewardship (AMS) and infection prevention and control (IPC) guidelines between COVID-19 and non-COVID-19 wards. The study was conducted in Sudan and Zambia, two resource constrained settings with differing country-wide responses to COVID-19. Methods Patients suspected of having hospital acquired infections were recruited from COVID-19 wards and non-COVID-19 wards. Bacteria were isolated from clinical samples using culture and molecular methods and species identified. Phenotypic and genotypic resistance patterns were determined by antibiotic disc diffusion and whole genome sequencing. Infection prevention and control guidelines were analysed for COVID-19 and non-COVID-19 wards to identify potential differences. Results 109 and 66 isolates were collected from Sudan and Zambia respectively. Phenotypic testing revealed significantly more multi-drug resistant isolates on COVID-19 wards in both countries (Sudan p = 0.0087, Zambia p = 0.0154). The total number of patients with hospital acquired infections (both susceptible and resistant) increased significantly on COVID-19 wards in Sudan, but the opposite was observed in Zambia (both p = ≤ 0.0001). Genotypic analysis showed significantly more β-lactam genes per isolate on COVID-19 wards (Sudan p = 0.0192, Zambia p = ≤ 0.0001). Conclusions Changes in hospital acquired infections and AMR patterns were seen in COVID-19 patients on COVID-19 wards compared to COVID-19 negative patients on non-COVID-19 wards in Sudan and Zambia. These are likely due to a potentially complex combination of causes, including patient factors, but differing emphases on infection prevention and control, and antimicrobial stewardship policies on COVID-19 wards were highlighted.

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Fosfomycin Escherichia coli Resistance in Poultry Meat Associated with the Excessive use of Biocides During COVID-19

Guergueb

2024

Folia Veterinaria

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The emergence of antimicrobial resistance has become one of the major public health problems. Although antimicrobial resistance naturally develops over time, its prevalence has increased due to the use of antimicrobial agents in the health sector and other contexts. This paper focuses on the rise in fosfomycin resistance of Escherichia coli isolated from poultry meat, coinciding with the excessive use of biocides during the COVID-19 outbreak in Algeria. A total of 134 E. coli isolates were identified from poultry meat samples purchased from the same butcher’s shops before and after the emergence of the COVID-19 outbreak. Univariate analyses were conducted using the ANOVA test for continuous variables and the chi-squared test for categorical variables. Odds ratios (OR) and 95 % confidence intervals (CI) were utilized for statistically significant risk factors. Multivariable analysis was performed with binary logistic regression to detect an independent predictor. A P-value of 0.05 was considered to indicate statistical significance. Poultry meat purchased after the COVID-19 appearance was found to be associated with fosfomycin-resistant E. coli; fosfomycin-resistant E. coli isolates were more prevalent after COVID-19 (15.56 %) than before the COVID-19 outbreak (1.69 %). A significant difference in fosfomycin E. coli resistance was observed before and after the COVID-19 emergence (P = 0.009; OR = 10.68; 95 % CI 1.26–90.34). E. coli strains isolated from poultry meat are 10 times more likely to be fosfomycin resistant after COVID-19 than before the COVID-19 outbreak. It could be that the excessive use of biocides during the COVID-19 outbreak increased the risk of fosfomycin E. coli resistance in poultry meat.

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Cropping Up Crisis at the Nexus Between COVID-19 and Antimicrobial Resistance (AMR) in Africa: A Scoping Review and Synthesis of Early Evidence

Cited by 3 publications

References 59 publications

Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic

Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic

A pandemic within a pandemic? Admission to COVID-19 wards in hospitals is associated with increased prevalence of antimicrobial resistance in two African settings

Fosfomycin Escherichia coli Resistance in Poultry Meat Associated with the Excessive use of Biocides During COVID-19

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