This study systematically analyzed the changes in antimicrobial resistance and antibiotic usage patterns for Klebsiella, Acinetobacter, and Pseudomonas aeruginosa in both COVID-19 and non-COVID-19 wards of a tertiary hospital in Slovakia from 2018 to 2024, revealing the significant impact of the pandemic on multidrug-resistant strains.
Literature Overview
This paper, titled 'Antimicrobial Resistance Trends, Resistance Mechanisms, and Antibiotic Consumption in COVID-19 Versus Non-COVID-19 Units: A Seven-Year Retrospective Cohort Study,' published in the journal Antibiotics, reviews and summarizes the resistance trends and antibiotic usage patterns of Klebsiella, Acinetobacter, and Pseudomonas aeruginosa in both COVID-19 and non-COVID-19 hospital units from 2018 to 2024.
Background Knowledge
Antimicrobial resistance (AMR) represents a critical challenge in global public health, especially during pandemic peaks when antimicrobial use significantly increased, raising the risk of transmission of drug-resistant strains. Klebsiella, Acinetobacter, and Pseudomonas aeruginosa are common hospital-acquired pathogens with complex resistance mechanisms, including ESBLs, carbapenemases, and efflux pump-mediated resistance. This study focuses on the epidemiological changes of these pathogens in different wards and combines antibiotic usage data to explore potential drivers of increased resistance, such as broad-spectrum antibiotic selective pressure and weakened infection control measures. Additionally, it analyzes the correlation between resistance mechanisms and antibiotic consumption to provide empirical support for antimicrobial stewardship.
Research Methods and Experiments
This study employed a retrospective cohort analysis covering clinical isolate data from 2018 to 2024, comparing hospitalization trends, pathogen incidence, resistance changes, and antibiotic usage across different hospital wards (including both COVID-19 and non-COVID-19 units). Statistical methods (e.g., linear regression, Spearman correlation analysis) were used to evaluate trends in resistance and associations between antibiotic consumption and resistance mechanisms.
Key Conclusions and Perspectives
Research Significance and Prospects
This study highlights the profound impact of the pandemic on the spread of resistance and antibiotic usage patterns within hospitals, underscoring the importance of antimicrobial stewardship strategies targeting drug-resistant pathogens. Future efforts should focus on strengthening hospital infection control and reducing the misuse of broad-spectrum antibiotics to delay further dissemination of resistance mechanisms. Continuous monitoring of resistance trends is also necessary to evaluate the effectiveness of antimicrobial interventions, particularly in intensive care units.
Conclusion
This study systematically analyzed antimicrobial resistance trends and antibiotic usage in Klebsiella, Acinetobacter, and Pseudomonas aeruginosa across different hospital wards in a tertiary Slovak hospital between 2018 and 2024. The findings revealed that while overall hospitalization rates declined during the pandemic, the detection of drug-resistant strains significantly increased, particularly in COVID-19 wards. Antimicrobial usage patterns also shifted, with increased use of broad-spectrum β-lactams and carbapenems and decreased fluoroquinolone use. Resistance mechanisms such as carbapenemases and efflux pumps became more prevalent during peak pandemic periods, severely limiting treatment options to mainly polymyxin E. The study emphasizes the critical role of antimicrobial stewardship during public health emergencies like pandemics to reduce the spread of resistant strains and ensure effective clinical treatment.
