The impact of COVID-19 on antibiotic resistance and clinical outcomes among critically ill patients

Khaled Al Oweidat; Ahmad A Toubasi; Farah A Khraisat; Moayad N Aldahabi; Ahmad Alghrabli; Yasmeen Khater; Noor Saleh; Thuraya N Al-Sayegh; Asma S Albtoosh

doi:10.1016/j.ajic.2023.12.009

The impact of COVID-19 on antibiotic resistance and clinical outcomes among critically ill patients

Am J Infect Control. 2024 May;52(5):546-551. doi: 10.1016/j.ajic.2023.12.009. Epub 2023 Dec 22.

Authors

Khaled Al Oweidat¹, Ahmad A Toubasi², Farah A Khraisat³, Moayad N Aldahabi³, Ahmad Alghrabli⁴, Yasmeen Khater⁴, Noor Saleh⁵, Thuraya N Al-Sayegh³, Asma S Albtoosh¹

Affiliations

¹ Associate Professor at the Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
² Faculty of Medicine, The University of Jordan, Amman, Jordan. Electronic address: tubasi_ahmad@yahoo.com.
³ Faculty of Medicine, The University of Jordan, Amman, Jordan.
⁴ Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
⁵ Critical Care Fellow at the Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan.

PMID: 38142778
DOI: 10.1016/j.ajic.2023.12.009

Abstract

Background: There is conflicting evidence regarding the impact of the Coronavirus 2019 (COVID-19) pandemic on antimicrobial resistance, with few studies conducted in low- and middle-income countries. We investigated the impact of the COVID-19 pandemic on multidrug resistant organisms (MDROs) among critically ill patients and their clinical outcomes.

Methods: This was a retrospective observational study of patients admitted to the medical Intensive Care Unit at Jordan University Hospital and had blood, urine, or bronchoalveolar bacterial cultures taken during 2 time periods: prepandemic (ie, 1/2016 to 1/2019) and pandemic (ie, 1/2020 to 1/2023). We compared the clinical outcomes (ie, in-hospital deaths, the need for O₂ devices, intubation, the length of hospital stay, and the occurrence of complications) and prevalence of MDROs between the 2 periods and conducted multivariate analyses.

Results: There were 1,254 patients (479 prepandemic and 775 postpandemic. The percentage of patients who had MDROs was significantly higher among patients with a culture taken during the pandemic (82.4%) compared to before it (17.6%) (P-value=.000). Multivariate analysis demonstrated that patients cultured during the pandemic were more than 3 times as likely to have an MDRO (odds ratio = 3.210; 95% confidence interval: 2.236-4.609).

Conclusions: The increase in MDROs during the COVID-19 pandemic is an alarming threat to public health; thus, investigating the antibiotic resistance situation as the pandemic subsides is crucial.

Keywords: Critically ill patients; Drug resistant organisms; Human; Pandemic.