Pinheiro Felipe Ramos, Rozza-de-Menezes Rafaela Elvira, Blum Marina Camille, Pereira Renata Freire Alves, Rocha Jaqueline Abel, Guedes Pinto Maria Cristina F, Penna Bruno A, Riley Lee W, Aguiar-Alves Fabio
Molecular Epidemiology and Biotechnology Laboratory, School of Pharmacy, Fluminense Federal University, Niteroi, Brazil.
Pathology Post Graduate Program, School of Medicine, Fluminense Federal University, Niteroi, Brazil.
Front Microbiol. 2023 Feb 20;14:1096223. doi: 10.3389/fmicb.2023.1096223. eCollection 2023.
The World Health Organization released a statement warning of increased risk for the incidence of multidrug resistant microorganisms and the absence of new drugs to control such infections soon. Since the beginning of the COVID-19 pandemic, the prescription of antimicrobial agents has increased and may have accelerated the emergence of multidrug resistant (MDR) bacteria. This study aimed to evaluate maternal and pediatric infections within a hospital from January 2019 to December 2021. An observational retrospective cohort study was performed at a quaternary referral hospital in a metropolitan area of Niteroi city, Rio de Janeiro state, Brazil. A total of 196 patients' medical records were analyzed. The data from 90 (45.9%) patients were collected before the SARS-CoV-2 pandemic, 29 (14.8%) from the 2020 pandemic period, and 77 (39.3%) from the 2021 pandemic period. A total of 256 microorganisms were identified during this period. Out of those, 101 (39.5%) were isolated in 2019, 51 (19.9%) in 2020, and 104 (40.6%) in 2021. Antimicrobial susceptibility tests were performed on 196 (76.6%) clinical isolates. The exact binomial test showed that the distribution of Gram-negative bacteria was predominant. The most common microorganism was (23%; = 45), followed by (17.9%, = 35), (12.8%, = 25), (7.7%, = 15), (6.6%, = 13) and (5.6%, = 11). was the predominant species among resistant bacteria. Among the antimicrobial agents tested, the following were resistant, presented on a descending scale: penicillin (72.7%, = 0.001, Binomial test), oxacillin (68.3%, = 0.006, Binomial test), ampicillin (64.3%, = 0.003, Binomial test), and ampicillin/sulbactam (54.9%, = 0.57, Binomial test). Infections with were 3.1 times greater in pediatrics and maternal units than in other hospital wards. Despite the global reduction in the incidence of MRSA, we observed an increase in MDR in this study. No changes were observed in the frequency of resistance profiles of the clinical isolates after the establishment of the global SARS-CoV-2 pandemic. More comprehensive studies are needed to understand the impact of the global SARS-CoV-2 pandemic on the resistance levels of bacteria associated with neonate and pediatric patients.
世界卫生组织发布声明，警告多重耐药微生物的发病率风险增加，且短期内缺乏控制此类感染的新药。自新冠疫情开始以来，抗菌药物的处方量增加，这可能加速了多重耐药（MDR）细菌的出现。本研究旨在评估2019年1月至2021年12月一家医院内的母婴感染情况。在巴西里约热内卢州尼泰罗伊市一个大都市地区的一家四级转诊医院进行了一项观察性回顾性队列研究。共分析了196例患者的病历。90例（45.9%）患者的数据收集于新冠病毒大流行之前，29例（14.8%）来自2020年大流行期间，77例（39.3%）来自2021年大流行期间。在此期间共鉴定出256种微生物。其中，2019年分离出101种（39.5%），2020年分离出51种（19.9%），2021年分离出104种（40.6%）。对196株（76.6%）临床分离株进行了药敏试验。确切二项式检验表明革兰氏阴性菌的分布占主导。最常见的微生物是[具体微生物1]（23%；共45株），其次是[具体微生物2]（17.9%，共35株），[具体微生物3]（12.8%，共25株），[具体微生物4]（7.7%，共15株），[具体微生物5]（6.6%，共13株）和[具体微生物6]（5.6%，共11株）。[具体耐药菌]是耐药细菌中的主要菌种。在所测试的抗菌药物中，以下药物的耐药情况按降序排列：青霉素（72.7%，确切概率检验P = 0.001）、苯唑西林（68.3%，确切概率检验P = 0.006）、氨苄西林（64.3%，确切概率检验P = 0.003）和氨苄西林/舒巴坦（54.9%，确切概率检验P = 0.57）。儿科和母婴病房中[具体感染菌]感染的发生率比其他医院病房高3.1倍。尽管全球耐甲氧西林金黄色葡萄球菌（MRSA）的发病率有所下降，但在本研究中我们观察到多重耐药[具体菌]有所增加。在全球新冠病毒大流行确立后，临床分离株的耐药谱频率未观察到变化。需要进行更全面的研究以了解全球新冠病毒大流行对与新生儿和儿科患者相关细菌耐药水平的影响。
