Antimicrobial resistance pattern in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait

Walid Q Alali; Naglaa M Abdo; Wadha AlFouzan; Rita Dhar

doi:10.18683/germs.2022.1341

Antimicrobial resistance pattern in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait

Germs. 2022 Sep 30;12(3):372-383. doi: 10.18683/germs.2022.1341. eCollection 2022 Sep.

Authors

Walid Q Alali¹, Naglaa M Abdo², Wadha AlFouzan³, Rita Dhar⁴

Affiliations

¹ DVM, MS, PhD, Department of Epidemiology & Biostatistics, Faculty of Public Health, Kuwait University, Sabah AlSalem Education City, 12 Street, Andalous, postal code 65000, Kuwait.
² MD, PhD, Department of Infection Control, Farwaniya Hospital, Ministry of Health, Sabah Al Nasser, postal code 85000, Kuwait, and Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Shaibet an Nakareyah, Zagazig, postal code 44519, Egypt.
³ MD, PhD, Department of Microbiology, Faculty of Medicine, Kuwait University, Fourth Ring Rd, Jabriya, postal code 13060, Kuwait, and Microbiology Unit, Department of Laboratories, Farwaniya Hospital, Farwaniya, Sabah Al Nasser, postal code 85000, Kuwait.
⁴ MD, Microbiology Unit, Department of Laboratories, Farwaniya Hospital, Farwaniya, Sabah Al Nasser, postal code 85000, Kuwait.

Abstract

Introduction: The study objective was to compare the prevalence of antimicrobial resistance (AMR) in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait.

Methods: A retrospective descriptive study was conducted based on AMR profiles of clinical Escherichia coli and Pseudomonas aeruginosa isolates. The AMR data represented isolates from five specimen types (body fluids; blood; respiratory; wound, bone, or other tissues; and urine) of patients admitted to four wards (surgical, medical, pediatric, and maternal-postnatal). Tested isolates between January 2019 and February 2020 represented the pre-COVID-19 pandemic period in Kuwait, whereas those from February 2020 until April 2021 represented the 'during COVID-19' period.

Results: A total of 1,303 isolates (57.2% E. coli and 42.8% P. aeruginosa) were analyzed. For ceftazidime, ertapenem and meropenem, the prevalence of AMR in E. coli was significantly (p<0.05) lower in pre-COVID-19 wards compared to that during COVID-19, whereas for other antibiotics (i.e., cefepime, gentamicin, and trimethoprim/sulfamethoxazole), the prevalence of AMR in pre-COVID-19 was significantly higher than that during COVID-19. The prevalence of AMR to gentamicin in P. aeruginosa isolates from non-COVID-19 wards (52.8%) was significantly higher (p<0.001) than that from COVID-19 wards (35.0%) and from the pre-COVID-19 period (32.9%). The multidrug-resistance (MDR) prevalence was 37.4% for E. coli and 32.1% for P. aeruginosa isolates. The odds of MDR in E. coli isolates from the COVID-19 medical wards were significantly lower (OR=0.27, [95%CI: 0.09-0.80], p=0.018) compared to the pre-COVID-19 wards. The odds of MDR E. coli and P. aeruginosa isolates by COVID-19 status stratified by specimen type were not different (p>0.05).

Conclusions: No major differences in AMR in E. coli and P. aeruginosa prevalence by specimen type and wards prior to and during the COVID-19 pandemic was observed at this hospital. The high reported MDR prevalence calls for better infection control and prevention.

Keywords: Bacterial resistance; COVID-19 pandemic; Middle East; healthcare-associated infections; multidrug-resistance; public health.

GERMS.