Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic
This observational retrospective study aimed to analyze whether/how the spectrum of bacterial pathogens and their resistance to antibiotics changed during the worst part of the COVID-19 pandemic (1 November 2020 to 30 April 2021) among intensive care patients in University Hospital Olomouc, Czech Re...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/6/783 |
| _version_ | 1797490621949149184 |
|---|---|
| author | Lenka Doubravská Miroslava Htoutou Sedláková Kateřina Fišerová Vendula Pudová Karel Urbánek Jana Petrželová Magdalena Röderová Kateřina Langová Kristýna Mezerová Pavla Kučová Karel Axmann Milan Kolář |
| author_facet | Lenka Doubravská Miroslava Htoutou Sedláková Kateřina Fišerová Vendula Pudová Karel Urbánek Jana Petrželová Magdalena Röderová Kateřina Langová Kristýna Mezerová Pavla Kučová Karel Axmann Milan Kolář |
| author_sort | Lenka Doubravská |
| collection | DOAJ |
| description | This observational retrospective study aimed to analyze whether/how the spectrum of bacterial pathogens and their resistance to antibiotics changed during the worst part of the COVID-19 pandemic (1 November 2020 to 30 April 2021) among intensive care patients in University Hospital Olomouc, Czech Republic, as compared with the pre-pandemic period (1 November 2018 to 30 April 2019). A total of 789 clinically important bacterial isolates from 189 patients were cultured during the pre-COVID-19 period. The most frequent etiologic agents causing nosocomial infections were strains of <i>Klebsiella pneumoniae</i> (17%), <i>Pseudomonas aeruginosa</i> (11%), <i>Escherichia coli</i> (10%), coagulase-negative staphylococci (9%), <i>Burkholderia multivorans</i> (8%), <i>Enterococcus faecium</i> (6%), <i>Enterococcus faecalis</i> (5%), <i>Proteus mirabilis</i> (5%) and <i>Staphylococcus aureus</i> (5%). Over the comparable COVID-19 period, a total of 1500 bacterial isolates from 372 SARS-CoV-2-positive patients were assessed. While the percentage of etiological agents causing nosocomial infections increased in <i>Enterococcus faecium</i> (from 6% to 19%, <i>p</i> < 0.0001), <i>Klebsiella variicola</i> (from 1% to 6%, <i>p</i> = 0.0004) and <i>Serratia marcescens</i> (from 1% to 8%, <i>p</i> < 0.0001), there were significant decreases in <i>Escherichia coli</i> (from 10% to 3%, <i>p</i> < 0.0001), <i>Proteus mirabilis</i> (from 5% to 2%, <i>p</i> = 0.004) and <i>Staphylococcus aureus</i> (from 5% to 2%, <i>p</i> = 0.004). The study demonstrated that the changes in bacterial resistance to antibiotics are ambiguous. An increase in the frequency of ESBL-positive strains of some species (<i>Serratia marcescens</i> and <i>Enterobacter cloacae</i>) was confirmed; on the other hand, resistance decreased (<i>Escherichia coli</i>, <i>Acinetobacter baumannii</i>) or the proportion of resistant strains remained unchanged over both periods (<i>Klebsiella pneumoniae</i>, <i>Enterococcus faecium</i>). Changes in pathogen distribution and resistance were caused partly due to antibiotic selection pressure (cefotaxime consumption increased significantly in the COVID-19 period), but mainly due to clonal spread of identical bacterial isolates from patient to patient, which was confirmed by the pulse field gel electrophoresis methodology. In addition to the above shown results, the importance of infection prevention and control in healthcare facilities is discussed, not only for dealing with SARS-CoV-2 but also for limiting the spread of bacteria. |
| first_indexed | 2024-03-10T00:35:38Z |
| format | Article |
| id | doaj.art-aa344e0ffe0440de85573779aaccb8f0 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T00:35:38Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-aa344e0ffe0440de85573779aaccb8f02023-11-23T15:17:13ZengMDPI AGAntibiotics2079-63822022-06-0111678310.3390/antibiotics11060783Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech RepublicLenka Doubravská0Miroslava Htoutou Sedláková1Kateřina Fišerová2Vendula Pudová3Karel Urbánek4Jana Petrželová5Magdalena Röderová6Kateřina Langová7Kristýna Mezerová8Pavla Kučová9Karel Axmann10Milan Kolář11Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicDepartment of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicDepartment of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Anesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, I. P. Pavlova 6, 779 00 Olomouc, Czech RepublicDepartment of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 779 00 Olomouc, Czech RepublicThis observational retrospective study aimed to analyze whether/how the spectrum of bacterial pathogens and their resistance to antibiotics changed during the worst part of the COVID-19 pandemic (1 November 2020 to 30 April 2021) among intensive care patients in University Hospital Olomouc, Czech Republic, as compared with the pre-pandemic period (1 November 2018 to 30 April 2019). A total of 789 clinically important bacterial isolates from 189 patients were cultured during the pre-COVID-19 period. The most frequent etiologic agents causing nosocomial infections were strains of <i>Klebsiella pneumoniae</i> (17%), <i>Pseudomonas aeruginosa</i> (11%), <i>Escherichia coli</i> (10%), coagulase-negative staphylococci (9%), <i>Burkholderia multivorans</i> (8%), <i>Enterococcus faecium</i> (6%), <i>Enterococcus faecalis</i> (5%), <i>Proteus mirabilis</i> (5%) and <i>Staphylococcus aureus</i> (5%). Over the comparable COVID-19 period, a total of 1500 bacterial isolates from 372 SARS-CoV-2-positive patients were assessed. While the percentage of etiological agents causing nosocomial infections increased in <i>Enterococcus faecium</i> (from 6% to 19%, <i>p</i> < 0.0001), <i>Klebsiella variicola</i> (from 1% to 6%, <i>p</i> = 0.0004) and <i>Serratia marcescens</i> (from 1% to 8%, <i>p</i> < 0.0001), there were significant decreases in <i>Escherichia coli</i> (from 10% to 3%, <i>p</i> < 0.0001), <i>Proteus mirabilis</i> (from 5% to 2%, <i>p</i> = 0.004) and <i>Staphylococcus aureus</i> (from 5% to 2%, <i>p</i> = 0.004). The study demonstrated that the changes in bacterial resistance to antibiotics are ambiguous. An increase in the frequency of ESBL-positive strains of some species (<i>Serratia marcescens</i> and <i>Enterobacter cloacae</i>) was confirmed; on the other hand, resistance decreased (<i>Escherichia coli</i>, <i>Acinetobacter baumannii</i>) or the proportion of resistant strains remained unchanged over both periods (<i>Klebsiella pneumoniae</i>, <i>Enterococcus faecium</i>). Changes in pathogen distribution and resistance were caused partly due to antibiotic selection pressure (cefotaxime consumption increased significantly in the COVID-19 period), but mainly due to clonal spread of identical bacterial isolates from patient to patient, which was confirmed by the pulse field gel electrophoresis methodology. In addition to the above shown results, the importance of infection prevention and control in healthcare facilities is discussed, not only for dealing with SARS-CoV-2 but also for limiting the spread of bacteria.https://www.mdpi.com/2079-6382/11/6/783COVID-19bacteriaantibioticsmultidrug resistance |
| spellingShingle | Lenka Doubravská Miroslava Htoutou Sedláková Kateřina Fišerová Vendula Pudová Karel Urbánek Jana Petrželová Magdalena Röderová Kateřina Langová Kristýna Mezerová Pavla Kučová Karel Axmann Milan Kolář Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic Antibiotics COVID-19 bacteria antibiotics multidrug resistance |
| title | Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic |
| title_full | Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic |
| title_fullStr | Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic |
| title_full_unstemmed | Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic |
| title_short | Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic |
| title_sort | bacterial resistance to antibiotics and clonal spread in covid 19 positive patients on a tertiary hospital intensive care unit czech republic |
| topic | COVID-19 bacteria antibiotics multidrug resistance |
| url | https://www.mdpi.com/2079-6382/11/6/783 |
| work_keys_str_mv | AT lenkadoubravska bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT miroslavahtoutousedlakova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT katerinafiserova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT vendulapudova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT karelurbanek bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT janapetrzelova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT magdalenaroderova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT katerinalangova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT kristynamezerova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT pavlakucova bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT karelaxmann bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic AT milankolar bacterialresistancetoantibioticsandclonalspreadincovid19positivepatientsonatertiaryhospitalintensivecareunitczechrepublic |