The impact of the pandemic on antimicrobial resistance and antibiotic use in a University Research and Practice Hospital in Türkiye

Introduction Antibacterial resistance and the increase in the number of infections caused by multidrug resistant bacteria threaten human health. The COVID-19 pandemic can have a positive or negative effect on antibacterial resistance. Hypothesis Antibacterial consumption and antibacterial resistance must have decreased in hospitals during the pandemic period. Aim This study was conducted to investigate how the pandemic affected the bacterial distribution, antibacterial resistance and antibiotic consumption in our hospital. Method The distribution of bacterial isolation and antibacterial resistance in same, in blood, urine and lower respiratory tract cultures of hospitalized patients between 01.04.2018 and 31.03.2022 were investigated. In addition, the consumption of commonly used antibacterials before and during the pandemic was evaluated by standardizing it according to the daily dose defined per 1000 days of inpatient treatment. Results In both periods, coagulase-negative staphylococci were the most frequently isolated bacterial species in blood cultures, E. coli in urine cultures, and A. baumannii in lower respiratory tract cultures.  It was observed that the 3rd generation cephalosporin and carbapenem resistance and extended-spectrum beta-lactamase (ESBL) rate of E. coli and K. pneumoniae isolates increased during the pandemic period. Antibiotic consumption had also increased. Conclussion The pandemic did not have a significant effect on the bacterial distribution in our hospital. Contrary to our wishes, an increase in antibiotic consumption and antibacterial resistance was observed. Our results show that we are one of the institutions that could not turn the COVID-19 pandemic into an advantage to reduce antibiotic consumption and antibacterial resistance. Approaches to reduce antibiotic resistance should be prioritized.