Merve Buyukcelik

Introduction. Antibacterial resistance and the increasing number of infections caused by multidrug-resistant bacteria threaten human health worldwide. The coronavirus disease 2019 (COVID-19) pandemic may have influenced antibacterial resistance patterns through changes in infection control practices and antibiotic prescribing. Aim. This single-centre, retrospective study aimed to describe changes in bacterial distribution, antibacterial resistance and antibiotic consumption in a university research and practice hospital before and during the COVID-19 pandemic. Methods. We analysed routine microbiology and pharmacy records from hospitalized patients between 01 April 2018 and 31 March 2022. The 2 years before 01 April 2020 was defined as the pre-pandemic period and the 2 years after 01 April 2020 as the pandemic period. Bacteria isolated from blood, urine and lower respiratory tract cultures, together with their antimicrobial susceptibility profiles, were compared between periods according to EUCAST criteria. Antibiotic consumption was calculated as defined daily doses per 1,000 inpatient days for commonly used agents. No patient-level clinical data or ward/ICU stratification was available. Results. A total of 7,275 isolates from 47,729 culture samples were obtained in the pre-pandemic period and 5,794 isolates from 47,210 samples during the pandemic. Coagulase-negative staphylococci remained the most frequently isolated species from blood cultures, Escherichia coli from urine cultures and Acinetobacter baumannii from lower respiratory tract cultures in both periods. Extended-spectrum β-lactamase (ESBL) rates and carbapenem resistance in E. coli and Klebsiella pneumoniae increased significantly during the pandemic, whereas teicoplanin and linezolid resistance in coagulase-negative staphylococci decreased. Carbapenem resistance in A. baumannii also decreased. Overall antibiotic consumption increased for most agents, particularly cephalosporins, carbapenems, aminoglycosides and fluoroquinolones, while vancomycin use decreased. Conclusion. In this single-centre, retrospective analysis, the overall distribution of major bacterial species remained largely stable before and during the COVID-19 pandemic, whereas important changes were observed in antimicrobial resistance profiles and antibiotic consumption. The increase in ESBL and carbapenem resistance in Enterobacterales, together with higher use of broad-spectrum antibiotics, underlines the need for strengthened antimicrobial stewardship and continuous local surveillance.

Introduction Antibacterial resistance and the increasing number of infections caused by multidrug-resistant bacteria threaten human health worldwide. The coronavirus disease 2019 (COVID-19) pandemic may have influenced antibacterial resistance patterns through changes in infection control practices and antibiotic prescribing. Aim This single-centre, retrospective study aimed to describe changes in bacterial distribution, antibacterial resistance and antibiotic consumption in a university research and practice hospital before and during the COVID-19 pandemic. Methods We analysed routine microbiology and pharmacy records from hospitalized patients between 01.04.2018 and 31.03.2022. The two years before 01.04.2020 were defined as the pre-pandemic period and the two years after 01.04.2020 as the pandemic period. Bacteria isolated from blood, urine and lower respiratory tract cultures, together with their antimicrobial susceptibility profiles, were compared between periods according to EUCAST criteria. Antibiotic consumption was calculated as defined daily doses (DDD) per 1000 inpatient-days for commonly used agents. No patient-level clinical data or ward/ICU stratification were available. Results A total of 7275 isolates from 47,729 culture samples were obtained in the pre-pandemic period and 5794 isolates from 47,210 samples during the pandemic. Coagulase-negative staphylococci remained the most frequently isolated species from blood cultures, Escherichia coli from urine cultures and Acinetobacter baumannii from lower respiratory tract cultures in both periods. Extended-spectrum β-lactamase (ESBL) rates and carbapenem resistance in E. coli and Klebsiella pneumoniae increased significantly during the pandemic, whereas teicoplanin and linezolid resistance in coagulase-negative staphylococci decreased. Carbapenem resistance in A. baumannii also decreased. Overall antibiotic consumption increased for most agents, particularly cephalosporins, carbapenems, aminoglycosides and fluoroquinolones, while vancomycin use decreased. Conclusion In this single-centre, retrospective analysis, the overall distribution of major bacterial species remained largely stable before and during the COVID-19 pandemic, whereas important changes were observed in antimicrobial resistance profiles and antibiotic consumption. The increase in ESBL and carbapenem resistance in Enterobacterales, together with higher use of broad-spectrum antibiotics, underlines the need for strengthened antimicrobial stewardship and continuous local surveillance.

Introduction Antibacterial resistance and the increasing number of infections caused by multidrug-resistant bacteria threaten human health worldwide. The coronavirus disease 2019 (COVID-19) pandemic may have influenced antibacterial resistance patterns through changes in infection control practices and antibiotic prescribing. Aim This single-centre, retrospective study aimed to describe changes in bacterial distribution, antibacterial resistance and antibiotic consumption in a university research and practice hospital before and during the COVID-19 pandemic. Methods We analysed routine microbiology and pharmacy records from hospitalized patients between 01.04.2018 and 31.03.2022. The two years before 01.04.2020 were defined as the pre-pandemic period and the two years after 01.04.2020 as the pandemic period. Bacteria isolated from blood, urine and lower respiratory tract cultures, together with their antimicrobial susceptibility profiles, were compared between periods according to EUCAST criteria. Antibiotic consumption was calculated as defined daily doses (DDD) per 1000 inpatient-days for commonly used agents. No patient-level clinical data or ward/ICU stratification were available. Results A total of 7275 isolates from 47,729 culture samples were obtained in the pre-pandemic period and 5794 isolates from 47,210 samples during the pandemic. Coagulase-negative staphylococci remained the most frequently isolated species from blood cultures, Escherichia coli from urine cultures and Acinetobacter baumannii from lower respiratory tract cultures in both periods. Extended-spectrum β-lactamase (ESBL) rates and carbapenem resistance in E. coli and Klebsiella pneumoniae increased significantly during the pandemic, whereas teicoplanin and linezolid resistance in coagulase-negative staphylococci decreased. Carbapenem resistance in A. baumannii also decreased. Overall antibiotic consumption increased for most agents, particularly cephalosporins, carbapenems, aminoglycosides and fluoroquinolones, while vancomycin use decreased. Conclusion In this single-centre, retrospective analysis, the overall distribution of major bacterial species remained largely stable before and during the COVID-19 pandemic, whereas important changes were observed in antimicrobial resistance profiles and antibiotic consumption. The increase in ESBL and carbapenem resistance in Enterobacterales, together with higher use of broad-spectrum antibiotics, underlines the need for strengthened antimicrobial stewardship and continuous local surveillance.

Introduction Antibacterial resistance and the increase in the number of infections caused by multidrug resistant bacteria threaten human health. The COVID-19 pandemic can have a positive or negative effect on antibacterial resistance. Hypothesis Antibacterial consumption and antibacterial resistance must have decreased in hospitals during the pandemic period. Aim This study was conducted to investigate how the pandemic affected the bacterial distribution, antibacterial resistance and antibiotic consumption in our hospital. Method The distribution of bacterial isolation and antibacterial resistance in same, in blood, urine and lower respiratory tract cultures of hospitalized patients between 01.04.2018 and 31.03.2022 were investigated. In addition, the consumption of commonly used antibacterials before and during the pandemic was evaluated by standardizing it according to the daily dose defined per 1000 days of inpatient treatment. Results In both periods, coagulase-negative staphylococci were the most frequently isolated bacterial species in blood cultures, E. coli in urine cultures, and A. baumannii in lower respiratory tract cultures. It was observed that the 3rd generation cephalosporin and carbapenem resistance and extended-spectrum beta-lactamase (ESBL) rate of E. coli and K. pneumoniae isolates increased during the pandemic period. Antibiotic consumption had also increased. Conclussion The pandemic did not have a significant effect on the bacterial distribution in our hospital. Contrary to our wishes, an increase in antibiotic consumption and antibacterial resistance was observed. Our results show that we are one of the institutions that could not turn the COVID-19 pandemic into an advantage to reduce antibiotic consumption and antibacterial resistance. Approaches to reduce antibiotic resistance should be prioritized.

The importance of doctors’ knowledge and awareness of infectious diseases was felt worldwide during the COVID-19 pandemic. With this study, we aimed to evaluate the effect of the long and dynamic pandemic process on resident physicians’ knowledge and protective behaviors for infection control in a tertiary hospital setting and protective behaviors for infection control in a tertiary hospital setting. The population of this cross-sectional study consisted of assistant physicians working at Suleyman Demirel University Faculty of Medicine Training and Research Hospital. A questionnaire evaluating information and protective practices for COVID-19 was applied to the participants through face-to-face interviews using the convenience sampling method, with an interval of one year. In the second year of the pandemic, resident physicians’ awareness of the correct use of personal protective equipment decreased (p = 0.001). Despite the continuous training, it was determined that the residents preferred masks with high protection at a lower rate when they encountered patients who received oxygen support of 5 lt/min and above (p < 0.001). To prevent the spread of COVID-19 infection in the hospital as the pandemic progresses, it has been determined that resident physicians are less prone to evaluate possible infection symptoms in patients hospitalized for non-COVID-19 reasons (p = 0.013). As a result, the data we obtained showed that despite the regular training during the pandemic and the death of many health workers, the residents’ adherence to infection control and prevention practices, which also protect them, decreased significantly in the second year of the pandemic. These valuable data showed us that good knowledge does not predict good infection control and prevention practices. Our findings show that physicians need a new education system that motivates them. In addition, psychosocial determinants, physical and mental fatigue, and institutional control factors contributing to these results and affecting individual risk perception should be recognized and prevented.