Abstract
Antimicrobial resistance (AMR) is a global health issue that plays a significant role in morbidity and mortality, especially in immunocompromised patients. It also becomes a serious threat to the successful treatment of many bacterial infections. The widespread and irrelevant use of antibiotics in hospitals and local clinics is the leading cause of AMR. Under this scenario, the study was conducted in a tertiary care hospital in Lahore, Pakistan, from 2 August 2021 to 31 October 2021 to discover the prevalence of bacterial infections and AMR rates in COVID-19 patients admitted in surgical intensive care units (SICUs). Clinical samples were collected from the patients and we proceeded to identify bacterial isolates, followed by antibiotic susceptibility testing (AST) using the Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC). The data of other comorbidities were also collected from the patient’s medical record. The current study showed that the most common pathogens were E. coli (32%) and Klebsiella pneumoniae (17%). Most E. coli were resistant to ciprofloxacin (16.8%) and ampicillin (19.8%). Klebsiella pneumoniae were more resistant to ampicillin (13.3%) and amoxycillin (12.0%). The most common comorbidity was chronic kidney disease (CKD) and urinary tract infections (UTIs). Around 17 different types of antibiotic, the carbapenem, fluoroquinolones, aminoglycoside, and quinolones, were highly prevalent in ICU patients. The current study provides valuable data on the clinical implication of antibiotics consumed by COVID-19 patients in SICUs and the AMR rates, especially with different comorbidities.
Highlights
The pandemic of coronavirus disease 2019 (COVID-19) and antimicrobial resistance (AMR) are two simultaneous and interacting health concerns that provide significant learning opportunities
The current study was conducted among COVID-19 patients admitted in surgical intensive care units (SICUs) of tertiary care hospitals, requiring monitoring and special care to analyse the antibiotics utilisation pattern and determine the prevalence of Antimicrobial resistance (AMR)
Results of the current study showed that approximately 36% of COVID-19 patients had pneumonia followed by aspiration, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and hypertension
Summary
The pandemic of coronavirus disease 2019 (COVID-19) and antimicrobial resistance (AMR) are two simultaneous and interacting health concerns that provide significant learning opportunities. They may interact because, given the lack of particular therapies, there is a desire to employ current antimicrobials to treat critically ill COVID-19 patients [1]. The COVID-19 pandemic helps to illustrate the possible long-term effects of AMR, which is less severe but not less critical since their measurements and outcomes are comparable. COVID-19 infections have far exceeded bacterial co-infection and mortality rates compared to other common respiratory viral infections [2]. In individuals with COVID-19, bacterial co-infection has been linked to disease progression and prognosis
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