Antimicrobial resistance in the times of COVID-19 in a roman teaching hospital

Figures & data

Table 1. Multidrug Resistant Microorganisms and/or Alert Organism (MDRO_AL) observed in different quarters before and during SARS-CoV-2 pandemic (2019-2020).

	First quarter pre-COVID^1		Second quarter pre-COVID^2		First quarter of COVID pandemic^3		Second quarter of COVID pandemic ^4
MDRO_AL	no.patients	relative percentage	no.patients	relative percentage	no.patients	relative percentage	no.patients	relative percentage
Extend Spectrum beta-lactamases (ESBL)	221	29.1	275	33.9	172	26.4	230	23.3
Staphylococci- and / or MLSB-streptococci (MLSB)	129 (18)#	17.0	111 (31)	13.7	146 (43)	22.4	233 (23)	13.2
Enterobacteria resistant to carbapenems (CRE)	66	8.7	139	17.1	69	10.6	130	13.2
Enterococci resistant to vancomycin (VRE)	56	7.4	35	4.3	46	7.1	59	6.0
Acinetobacter spp.	50	6.6	65	8.0	50	7.7	116	11.8
CONS I/R to glycopeptides	47	6.2	41	5.1	50	7.7	88	8.9
C. difficile Toxin A/B Positive	41	5.4	30	3.7	28	4.3	22	2.2
C.difficile NAP1/O27	11	1.4	5	0.6	13	2.0	4	0.4
C.difficile binary toxin positive	22	2.8	14	1.7	17	2.6	7	0.7
Stenotrophomonas maltophilia	16	2.1	11	1.4	6	0.9	13	1.3
Pseudomonas MDR	14	1.8	29	3.6	5	0.8	5	0.5
Staphylococci /Streptococci linezolid resistant	11	1.4	11	1.4	5	0.8	13	1.3
S.aureus methycillin resistant (MRSA)	69	9.1	38	4.7	39	6.0	51	5.2
Aspergillus spp	7	0.9	4	0.5	6	0.9	12	1.2
Legionella pneumophila			2	0.2			3	0.3
S.pneumoniae penicillin resistant			1	0.0		0.0		0.0
Total	742		780		609		963
Fisher exact test	0.00001
Incidence rate	18.0		19.5		27.4		34.6

Legend for table 1

¹ and ² = ‘pre-COVID’ refers at the time when no SARS-CoV-2 was detected in patients admitted in our hospital, from 01/03/2019–31/05/2019 and 2 from 01/10/2019–31/12/2019, respectively;

³ and ⁴ ‘COVID pandemic’ refers to the pandemic time, from 01/03/2020–31/05/2020 and from 01/10/2020–31/12/2020, respectively

^# = number between brackets indicates the Staphylococci expressing MLSB phenotypes that were also CONS I/R to glycopetides

Table 2. Enterobacteria resistant to ceftazidime/avibactam isolates over the time.

	First quarter	Second quarter	First quarter of COVID	Second quarter of COVID
Resistance Phenotype	pre-COVID ^1 no.patients	pre-COVID ^2 no.patients	no.patients pandemic ^3	no.patients pandemic ^4
Enterobacteria resistant to carbapenems (CRE)	66	139	69	130
Enterobacteria resistant to ceftazidime/avibactam	0	3*	12^&	15^§

Legend to table 4

* =  all three isolates were K.pneumoniae KPC;

& = 2 isolates were K.pneumoniae KPC-VIM, 9 were K.pneumoniae KPC, one was K.oxytoca VIM;

§ = 7 were K.pneumoniae KPC, 2 were K.pneumoniae VIM, 2 were K.pneumoniae KPC + VIM, one E.coli VIM, one E.cloacae VIM, one E.bugandensis VIM, and one E.coli CTX-M

¹ = pre-COVID refers at the time when no SARS-CoV-2 was detected in patients admitted in our hospital, from 01/03/2019–31/05/2019; ² = from 01/10/2019–31/12/2019; ³ = COVID refers to the pandemic time, from 01/03/2020–31/05/2020; ⁴ = from 01/10/2020–31/12/2020

Table 3. DDD of some target-antibiotics in different quarters before and during SARS-CoV-2 pandemic (2019-2020).

Drug	DDD recorded in the First quarter pre-COVID ^1	DDD recorded in the Second quarter pre-COVID^2	DDD recorded in the First quarter of COVID pandemic ^3	DDD recorded in the Second quarter of COVID pandemic ^4
Ceftriaxon	9661	7775	4513	5658
Meropenem	2848	2181	1806	2280
Ceftazidime/Avibactam	300	546	557	853
Macrolides	5018	3834	8594	4670
Vancomicin; Teicoplanine	4123	3187	1781	2342

Legend for table 3.

¹ = pre-COVID refers at the time when no SARS-CoV-2 was detected in patients admitted in our hospital, from 01/03/2019 to 31/05/2019; ² = from 01/10/2019 to 31/12/2019; ³ = COVID refers to the pandemic time, from 01/03/2020 to 31/05/2020; ⁴ = from 01/10/2020 to 31/12/2020;