Carbapenem resistance charges in critically sick hospital sufferers in Brazil rose throughout the COVID-19 pandemic and have remained greater than pre-pandemic charges, researchers reported final week within the American Journal of An infection Management.
For the examine, researchers retrospectively analyzed information on all critically sick, mechanically ventilated adults admitted to eight Brazilian hospitals from January 1, 2018, to April 30, 2023, stratifying the sufferers into three durations: pre-surge (January 1, 2018, to March 1, 2020), surge (March 1, 2020, to October 1, 2021), and post-surge (after October 1, 2021). The primary end result was the variety of carbapenem-resistant gram-negative bacterial isolates throughout the three durations.
Brazil had one of many highest COVOD-19 burdens on this planet, and notable will increase in carbapenem use in Brazilian hospitals throughout the early months of the pandemic have beforehand been reported.
Considerations about resistance charges remaining ‘completely excessive’
Of the 9,780 sufferers included within the examine, 3,718 have been within the pre-surge, 3,185 within the surge, and a couple of,247 within the post-surge interval. The sufferers within the pre- and post-surge durations had related traits and outcomes, whereas the sufferers within the surge interval have been youthful (median age, 70 vs 74 pre-surge vs 75 post-surge), primarily male (57% vs 48% vs 51%), and had greater charges of mechanical air flow (7 vs 5 days pre- and post-surge).
The isolation of carbapenem-resistant gram-negative micro organism elevated throughout the surge (charge ratio [RR], 1.8; 95% confidence interval [CI], 1.5 to 2.2 in comparison with pre-surge), decreased in post-surge (RR, 0.72; 95% CI, 0.6 to 0.9), and remained greater than pre-surge (RR, 1.3; 95% CI, 1.0 to 1.6). Resistance charges for Pseudomonas aeruginosa fell from 32% to 23% pre- to post-surge, whereas Klebsiella pneumoniae doubled throughout the surge, 26% to 52%, and remained greater (42%) than pre-surge.
“In a post-COVID-19 world, with the emergence of latest infectious illnesses and ongoing challenges posed by present pathogens, the significance of preserving the effectiveness of antimicrobials can’t be overstated,” the examine authors wrote. “It’s essential to coordinate efforts to keep away from antimicrobial resistance charges remaining completely excessive and to stop future related antimicrobial stewardship breakdowns.”
