Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Arch Microbiol. 2024 May 9;206(6):250. doi: 10.1007/s00203-024-03965-x.
The widespread evolution of phenotypic resistance in clinical isolates over the years, coupled with the COVID-19 pandemic onset, has exacerbated the global challenge of antimicrobial resistance. This study aimed to explore changes in bacterial infection patterns and antimicrobial resistance during the COVID-19 pandemic. This study involved the periods before and during COVID-19: the pre-pandemic and pandemic eras. The surveillance results of bacterial isolates causing infections in cancer patients at an Egyptian tertiary oncology hospital were retrieved. The Vitek2 or Phoenix systems were utilized for species identification and susceptibility testing. Statistical analyses were performed comparing microbiological trends before and during the pandemic. Out of 2856 bacterial isolates, Gram-negative bacteria (GNB) predominated (69.7%), and Gram-positive bacteria (GPB) comprised 30.3% of isolates. No significant change was found in GNB prevalence during the pandemic (P = 0.159). Elevated rates of Klebsiella and Pseudomonas species were demonstrated during the pandemic, as was a decrease in E. coli and Acinetobacter species (P < 0.001, 0.018, < 0.001, and 0.046, respectively) in hematological patients. In surgical patients, Enterobacteriaceae significantly increased (P = 0.012), while non-fermenters significantly decreased (P = 0.007). GPB species from either hematological or surgical wards exhibited no notable changes during the pandemic. GNB resistance increased in hematological patients to carbapenems, amikacin, and tigecycline and decreased in surgical patients to amikacin and cefoxitin (P < 0.001, 0.010, < 0.001, < 0.001, and 0.016, respectively). The study highlights notable shifts in the microbial landscape during the COVID-19 pandemic, particularly in the prevalence and resistance patterns of GNB in hematological and surgical wards.
多年来，临床分离株中表型耐药的广泛进化，加上 COVID-19 大流行的爆发，加剧了全球对抗微生物药物耐药性的挑战。本研究旨在探讨 COVID-19 大流行期间细菌感染模式和抗微生物药物耐药性的变化。本研究涉及 COVID-19 之前和期间的时期：大流行前和大流行时期。检索了埃及一家三级肿瘤医院癌症患者感染的细菌分离株的监测结果。使用 Vitek2 或 Phoenix 系统进行种属鉴定和药敏试验。比较大流行前后微生物趋势的统计学分析。在 2856 株细菌分离株中，革兰氏阴性菌（GNB）占主导地位（69.7%），革兰氏阳性菌（GPB）占 30.3%。大流行期间 GNB 的流行率没有明显变化（P=0.159）。大流行期间，肺炎克雷伯菌和铜绿假单胞菌的检出率升高，而大肠埃希菌和不动杆菌的检出率降低（P<0.001、0.018、<0.001 和 0.046）。血液科患者中。外科患者中肠杆菌科显著增加（P=0.012），而非发酵菌显著减少（P=0.007）。血液科或外科病房的 GPB 种属在大流行期间没有明显变化。血液科患者对碳青霉烯类、阿米卡星和替加环素的 GNB 耐药性增加，而外科患者对阿米卡星和头孢西丁的耐药性降低（P<0.001、0.010、<0.001、<0.001 和 0.016）。该研究强调了 COVID-19 大流行期间微生物景观的显著变化，特别是血液科和外科病房中 GNB 的流行率和耐药模式。
