Alali Walid Q, Abdo Naglaa M, AlFouzan Wadha, Dhar Rita
DVM, MS, PhD, Department of Epidemiology & Biostatistics, Faculty of Public Health, Kuwait University, Sabah AlSalem Education City, 12 Street, Andalous, postal code 65000, Kuwait.
MD, PhD, Department of Infection Control, Farwaniya Hospital, Ministry of Health, Sabah Al Nasser, postal code 85000, Kuwait, and Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Shaibet an Nakareyah, Zagazig, postal code 44519, Egypt.
Germs. 2022 Sep 30;12(3):372-383. doi: 10.18683/germs.2022.1341. eCollection 2022 Sep.
The study objective was to compare the prevalence of antimicrobial resistance (AMR) in clinical and isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait.
A retrospective descriptive study was conducted based on AMR profiles of clinical Escherichia coli and Pseudomonas aeruginosa isolates. The AMR data represented isolates from five specimen types (body fluids; blood; respiratory; wound, bone, or other tissues; and urine) of patients admitted to four wards (surgical, medical, pediatric, and maternal-postnatal). Tested isolates between January 2019 and February 2020 represented the pre-COVID-19 pandemic period in Kuwait, whereas those from February 2020 until April 2021 represented the 'during COVID-19' period.
A total of 1,303 isolates (57.2% and 42.8% ) were analyzed. For ceftazidime, ertapenem and meropenem, the prevalence of AMR in was significantly (p<0.05) lower in pre-COVID-19 wards compared to that during COVID-19, whereas for other antibiotics (i.e., cefepime, gentamicin, and trimethoprim/sulfamethoxazole), the prevalence of AMR in pre-COVID-19 was significantly higher than that during COVID-19. The prevalence of AMR to gentamicin in isolates from non-COVID-19 wards (52.8%) was significantly higher (p<0.001) than that from COVID-19 wards (35.0%) and from the pre-COVID-19 period (32.9%). The multidrug-resistance (MDR) prevalence was 37.4% for and 32.1% for isolates. The odds of MDR in isolates from the COVID-19 medical wards were significantly lower (OR=0.27, [95%CI: 0.09-0.80], p=0.018) compared to the pre-COVID-19 wards. The odds of MDR and isolates by COVID-19 status stratified by specimen type were not different (p>0.05).
No major differences in AMR in and prevalence by specimen type and wards prior to and during the COVID-19 pandemic was observed at this hospital. The high reported MDR prevalence calls for better infection control and prevention.
本研究的目的是比较科威特在新冠疫情之前及期间，一家二级护理医院临床分离株和从患者身上获取的分离株中抗菌药物耐药性（AMR）的流行情况。
基于临床大肠杆菌和铜绿假单胞菌分离株的AMR谱进行了一项回顾性描述性研究。AMR数据代表了入住四个病房（外科、内科、儿科和母婴产后病房）的患者的五种标本类型（体液；血液；呼吸道；伤口、骨骼或其他组织；以及尿液）的分离株。2019年1月至2020年2月期间检测的分离株代表科威特新冠疫情之前的时期，而2020年2月至2021年4月期间的分离株代表“新冠疫情期间”。
共分析了1303株分离株（分别占57.2%和42.8%）。对于头孢他啶、厄他培南和美罗培南，新冠疫情之前病房中AMR的流行率显著低于（p<0.05）新冠疫情期间，而对于其他抗生素（即头孢吡肟、庆大霉素和甲氧苄啶/磺胺甲恶唑），新冠疫情之前AMR的流行率显著高于新冠疫情期间。非新冠病房分离株中对庆大霉素的AMR流行率（52.8%）显著高于（p<0.001）新冠病房（35.0%）和新冠疫情之前的时期（32.9%）。多重耐药（MDR）流行率在大肠杆菌分离株中为37.4%，在铜绿假单胞菌分离株中为32.1%。与新冠疫情之前的病房相比，新冠内科病房分离株中MDR的几率显著更低（OR=0.27，[95%CI：0.09 - 0.80]，p=0.018）。按标本类型分层的新冠状态下大肠杆菌和铜绿假单胞菌分离株中MDR的几率没有差异（p>0.05）。
在这家医院，未观察到新冠疫情之前及期间按标本类型和病房划分的大肠杆菌和铜绿假单胞菌AMR流行情况的重大差异。报告的高MDR流行率要求更好地控制和预防感染。
