AUTHOR=Pinheiro Felipe Ramos , Rozza-de-Menezes Rafaela Elvira , Blum Marina Camille , Pereira Renata Freire Alves , Rocha Jaqueline Abel , Guedes Pinto Maria Cristina F. , Penna Bruno A. , Riley Lee W. , Aguiar-Alves Fabio 

TITLE=Evaluation of changes in antimicrobial susceptibility in bacteria infecting children and their mothers in pediatric, neonatal-intensive care unit, and gynecology/obstetrics wards of a quaternary referral hospital during the COVID-19 pandemic

JOURNAL=Frontiers in Microbiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1096223

DOI=10.3389/fmicb.2023.1096223

ISSN=1664-302X

ABSTRACT=<p>The World Health Organization released a statement warning of increased risk for the incidence of multidrug resistant microorganisms and the absence of new drugs to control such infections soon. Since the beginning of the COVID-19 pandemic, the prescription of antimicrobial agents has increased and may have accelerated the emergence of multidrug resistant (MDR) bacteria. This study aimed to evaluate maternal and pediatric infections within a hospital from January 2019 to December 2021. An observational retrospective cohort study was performed at a quaternary referral hospital in a metropolitan area of Niteroi city, Rio de Janeiro state, Brazil. A total of 196 patients’ medical records were analyzed. The data from 90 (45.9%) patients were collected before the SARS-CoV-2 pandemic, 29 (14.8%) from the 2020 pandemic period, and 77 (39.3%) from the 2021 pandemic period. A total of 256 microorganisms were identified during this period. Out of those, 101 (39.5%) were isolated in 2019, 51 (19.9%) in 2020, and 104 (40.6%) in 2021. Antimicrobial susceptibility tests were performed on 196 (76.6%) clinical isolates. The exact binomial test showed that the distribution of Gram-negative bacteria was predominant. The most common microorganism was <italic>Escherichia coli</italic> (23%; <italic>n</italic> = 45), followed by <italic>Staphylococcus aureus</italic> (17.9%, <italic>n</italic> = 35), <italic>Klebsiella pneumoniae</italic> (12.8%, <italic>n</italic> = 25), <italic>Enterococcus faecalis</italic> (7.7%, <italic>n</italic> = 15), <italic>Staphylococcus epidermidis</italic> (6.6%, <italic>n</italic> = 13) and <italic>Pseudomonas aeruginosa</italic> (5.6%, <italic>n</italic> = 11). <italic>Staphylococcus aureus</italic> was the predominant species among resistant bacteria. Among the antimicrobial agents tested, the following were resistant, presented on a descending scale: penicillin (72.7%, <italic>p</italic> = 0.001, Binomial test), oxacillin (68.3%, <italic>p</italic> = 0.006, Binomial test), ampicillin (64.3%, <italic>p</italic> = 0.003, Binomial test), and ampicillin/sulbactam (54.9%, <italic>p</italic> = 0.57, Binomial test). Infections with <italic>S. aureus</italic> were 3.1 times greater in pediatrics and maternal units than in other hospital wards. Despite the global reduction in the incidence of MRSA, we observed an increase in MDR <italic>S. aureus</italic> in this study. No changes were observed in the frequency of resistance profiles of the clinical isolates after the establishment of the global SARS-CoV-2 pandemic. More comprehensive studies are needed to understand the impact of the global SARS-CoV-2 pandemic on the resistance levels of bacteria associated with neonate and pediatric patients.</p>