| Title: | A time series analysis approach to quantify change in antibiotic resistance and antibiotic consumption during COVID-19 epidemics : a multicentre cross-national ecological study on behalf of QUantifying change in Antibiotic Resistance, ANTibiotic use, and INfection control during COVID-19 Epidemics study project |
|---|
| Authors: | ID Meschiari, Marianna (Author)
ID López Lozano, José María (Author)
ID Medioli, Filippo (Author)
ID Bacca, Erica (Author)
ID Sarti, Mario (Author)
ID Pirš, Mateja (Author)
ID Gregorčič, Sergeja (Author)
ID Beović, Bojana (Author), et al. |
|---|
| Files: |  PDF - Presentation file, download (6,00 MB)
MD5: 3379A571DDF89D7AC3B81D48F9511380
 URL - Source URL, visit https://www.clinicalmicrobiologyandinfection.org/article/S1198-743X(25)00296-4/fulltext
|
|---|
| Language: | English |
|---|
| Typology: | 1.01 - Original Scientific Article |
|---|
| Organization: |  UKC LJ - Ljubljana University Medical Centre
|
|---|
| Abstract: | Objectives: We aimed to assess the impact of COVID-19 on antibiotic consumption (AMC) and antimicrobial resistance (AMR) in the new epidemiological scenario from a cross-national perspective. Methods: A quasi-experimental retrospective multicentre ecological study was conducted to explore the impact of COVID-19 on AMC and AMR using routinely generated retrospective time series data. This study included nine Healthcare University Hospitals from Europe and Israel on behalf QUantifying change in Antibiotic Resistance, ANTibiotic use, and INfection control during COVID-19 Epidemics project. Total effects were defined as the difference between the pre-COVID-19 period (ranging from January 2015 or January 2016 to February 2020) and during the COVID-19 pandemic period (March 2020 to July 2021 or December 2021). The outcomes were incidence density (ID) of carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Escherichia coli, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa and Clostridioides difficile, as monthly isolates per 1000 patient days and the monthly AMC ranked according to the Access, Watch, and Reserve WHO classification system. Results: We assessed 15.9 million total hospital bed days, 315 736 COVID-19 bed days, 52 557 monthly bacterial isolates, and 461 739 monthly antimicrobial defined daily doses. The COVID-19 pandemic had a significant impact on the consumption of overall hospital antibiotics combined in all centres except two. Prescriptions for piperacillin/tazobactam, glycopeptides, and ceftazidime/avibactam increased, whereas third-generation cephalosporins, macrolides, and fluoroquinolones returned to pre-pandemic levels after an initial surge, in all centres. A positive relationship between the pandemic intensity and VRE ID was observed in 6 of 9 (66%) centres followed by methicillin-resistant S. aureus-ID and carbapenemresistant P. aeruginosa-ID 3 of 4 (44%) for both. A negative relationship was found for extendedspectrum beta-lactamase-producing E. coli ID. Discussion: The COVID-19 pandemic was associated with higher usage of broad-spectrum antibiotics and higher incidence of multidrug-resistant bacteria, with great variability by countries. These results could support international action plans that embed AMR as a priority in the post-COVID-19 era. |
|---|
| Keywords: | antibiotic consumption, antimicrobial resistance, COVID-19, multicentre, multi-drug resistant organisms, non-linear time series, thresholds |
|---|
| Publication status: | Published |
|---|
| Publication version: | Version of Record |
|---|
| Year of publishing: | 2025 |
|---|
| Number of pages: | str. 1500-1509 |
|---|
| Numbering: | Vol. 31, iss. 9 |
|---|
| PID: | 20.500.12556/DiRROS-27727  |
|---|
| UDC: | 616.9 |
|---|
| ISSN on article: | 1469-0691 |
|---|
| DOI: | 10.1016/j.cmi.2025.06.009 |
|---|
| COBISS.SI-ID: | 244976643 |
|---|
| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 6. 8. 2025;
|
|---|
| Publication date in DiRROS: | 23.02.2026 |
|---|
| Views: | 172 |
|---|
| Downloads: | 78 |
|---|
| Metadata: |    |
|---|
|
:
|
Copy citation |
|---|
| | | | Share: |  |
|---|
Hover the mouse pointer over a document title to show the abstract or click
on the title to get all document metadata. |
