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Article

Long-Term Impact of the COVID-19 Pandemic on In-Hospital Antibiotic Consumption and Antibiotic Resistance: A Time Series Analysis (2015–2021)

1
Department of Infectious Diseases, Azienda Ospedaliero-Universitaria of Modena, 41124 Modena, Italy
2
Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
3
Clinic of Infectious Diseases, Department of Infectious Diseases, University of Modena, 41124 Modena, Italy
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Clinical Microbiology Laboratory, Azienda Ospedaliero-Universitaria of Modena, 41124 Modena, Italy
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Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41124 Modena, Italy
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Medicine Preventive-Infection Control Team, Hospital Vega Baja, 03314 Orihuela-Alicante, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Mehran Monchi
Antibiotics 2022, 11(6), 826; https://doi.org/10.3390/antibiotics11060826
Received: 2 June 2022 / Revised: 15 June 2022 / Accepted: 17 June 2022 / Published: 20 June 2022
(This article belongs to the Special Issue Antimicrobial Use and Stewardship during the COVID-19 Era)
The coronavirus disease 2019 (COVID-19)-pandemic-related overload of health systems has compromised the application of antimicrobial stewardship (AS) models and infection prevention and control (IPC) programs. We aimed to evaluate the impact of COVID-19 on antimicrobial consumption (AC) and antimicrobial resistance (AMR) in the University Hospital of Modena. A time series analysis with an autoregressive integrated moving average model was conducted from January 2015 to October 2021 to evaluate the AC in the whole hospital and the intensive care unit (ICU), the incidence density (ID) of bloodstream infections (BSIs) due to the main multidrug-resistant organisms, and of C. difficile infections (CDIs). After an initial peak during the COVID-19 period, a decrease in the trend of AC was observed, both at the hospital (CT: −1.104, p = 0.025) and ICU levels (CT: −4.47, p = 0.047), with no significant difference in the single classes. Among the Gram-negative isolates, we observed a significant increase only in the level of BSIs due to carbapenem-susceptible Pseudomonas aeruginosa (CL: 1.477, 95% CI 0.130 to 2.824, p = 0.032). Considering Gram-positive bacteria, an increase in the level of BSIs due to methicillin-resistant Staphylococcus aureus and in the trend of CDIs were observed, though they did not reach statistical significance (CL: 0.72, 95% CI −0.039 to 1.48, p = 0.062; CT: 1.43, 95% CI −0.002 to 2.863, p = 0.051; respectively). Our findings demonstrated that the increases in AMR and AC that appeared in the first COVID-19 wave may be later controlled by restoring IPC and AS programs to pre-epidemic levels. A coordinated healthcare effort is necessary to address the longer-term impact of COVID-19 on AC to avoid irreversible consequences on AMR. View Full-Text
Keywords: COVID-19; infection control; antimicrobial stewardship; antimicrobial resistance; MDROs; Acinetobacter baumannii; Pseudomonas aeruginosa; Staphylococcus aureus; Escherichia coli; Clostridioides difficile COVID-19; infection control; antimicrobial stewardship; antimicrobial resistance; MDROs; Acinetobacter baumannii; Pseudomonas aeruginosa; Staphylococcus aureus; Escherichia coli; Clostridioides difficile
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MDPI and ACS Style

Meschiari, M.; Onorato, L.; Bacca, E.; Orlando, G.; Menozzi, M.; Franceschini, E.; Bedini, A.; Cervo, A.; Santoro, A.; Sarti, M.; Venturelli, C.; Biagioni, E.; Coloretti, I.; Busani, S.; Girardis, M.; Lòpez-Lozano, J.-M.; Mussini, C. Long-Term Impact of the COVID-19 Pandemic on In-Hospital Antibiotic Consumption and Antibiotic Resistance: A Time Series Analysis (2015–2021). Antibiotics 2022, 11, 826. https://doi.org/10.3390/antibiotics11060826

AMA Style

Meschiari M, Onorato L, Bacca E, Orlando G, Menozzi M, Franceschini E, Bedini A, Cervo A, Santoro A, Sarti M, Venturelli C, Biagioni E, Coloretti I, Busani S, Girardis M, Lòpez-Lozano J-M, Mussini C. Long-Term Impact of the COVID-19 Pandemic on In-Hospital Antibiotic Consumption and Antibiotic Resistance: A Time Series Analysis (2015–2021). Antibiotics. 2022; 11(6):826. https://doi.org/10.3390/antibiotics11060826

Chicago/Turabian Style

Meschiari, Marianna, Lorenzo Onorato, Erica Bacca, Gabriella Orlando, Marianna Menozzi, Erica Franceschini, Andrea Bedini, Adriana Cervo, Antonella Santoro, Mario Sarti, Claudia Venturelli, Emanuela Biagioni, Irene Coloretti, Stefano Busani, Massimo Girardis, José-María Lòpez-Lozano, and Cristina Mussini. 2022. "Long-Term Impact of the COVID-19 Pandemic on In-Hospital Antibiotic Consumption and Antibiotic Resistance: A Time Series Analysis (2015–2021)" Antibiotics 11, no. 6: 826. https://doi.org/10.3390/antibiotics11060826

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