Changes in Respiratory Microorganism Distribution and Antimicrobial Resistance Patterns in Intensive Care Units: A Comparative Analysis Before and During the COVID-19 Pandemic

Öz

This study aimed to evaluate changes in the distribution of microorganisms isolated from respiratory tract specimens and antimicrobial resistance patterns in intensive care units (ICUs) before and during the COVID-19 pandemic. Microbiological data from respiratory tract specimens obtained from patients admitted to the ICUs of a state hospital between January 1, 2019, and April 30, 2021, were retrospectively reviewed. The study period was divided into the pre-pandemic period (January 1, 2019–February 29, 2020) and the pandemic period (March 1, 2020–April 30, 2021). A total of 634 patients and 757 respiratory tract isolates were included. The median age was 79 years (IQR: 66–85), and 55.2% of the patients were male. Acinetobacter spp. was the most frequently isolated microorganism overall, followed by Klebsiella spp., Pseudomonas spp., Escherichia coli, and Staphylococcus aureus. Overall microorganism distribution differed significantly between the pre-pandemic and pandemic periods (p<0.001). Antimicrobial resistance analyses were performed for the most frequently isolated bacterial pathogens. No significant changes were observed in resistance rates among Pseudomonas spp. isolates. Among Acinetobacter spp. isolates, trimethoprim-sulfamethoxazole resistance increased significantly during the pandemic period. Among Klebsiella spp. isolates, trimethoprim-sulfamethoxazole resistance increased significantly. These findings indicate that the COVID-19 pandemic period was associated with changes in respiratory microorganism distribution and selected antimicrobial resistance patterns in ICUs.

Anahtar Kelimeler

• COVID-19
• intensive care unit
• respiratory tract specimens
• antimicrobial resistance
• Acinetobacter spp.
• Klebsiella spp.
• Pseudomonas spp.

Destekleyen Kurum

no

Proje Numarası

no

Etik Beyan

Approving Committee: Non-Interventional Clinical Research Ethics Committee of Sakarya University Faculty of Medicine Approval Date: 30.01.2024 Decision No: E-71522473/050.01.04-330358-25

Teşekkür

none

Yoğun Bakım Ünitelerinde Solunum Yolu Mikroorganizma Dağılımı ve Antimikrobiyal Direnç Paternlerindeki Değişimler: COVID-19 Pandemisi Öncesi ve Pandemi Döneminin Karşılaştırmalı Analizi

Öz

Bu çalışmada, COVID-19 pandemisi öncesi ve pandemi döneminde yoğun bakım ünitelerinde (YBÜ) solunum yolu örneklerinden izole edilen mikroorganizmaların dağılımı ve antimikrobiyal direnç paternlerindeki değişimlerin değerlendirilmesi amaçlandı. Bir devlet hastanesinin YBÜ’lerinde 1 Ocak 2019–30 Nisan 2021 tarihleri arasında yatan hastalardan alınan solunum yolu örneklerine ait mikrobiyolojik veriler retrospektif olarak incelendi. Çalışma dönemi pandemi öncesi dönem (1 Ocak 2019–29 Şubat 2020) ve pandemi dönemi (1 Mart 2020–30 Nisan 2021) olarak ikiye ayrıldı. Toplam 634 hasta ve 757 solunum yolu izolatı çalışmaya dahil edildi. Hastaların medyan yaşı 79 yıl (IQR: 66–85) olup, %55,2’si erkekti. Genel olarak en sık izole edilen mikroorganizma Acinetobacter spp. olup, bunu Klebsiella spp., Pseudomonas spp., Escherichia coli ve Staphylococcus aureus izledi. Mikroorganizma dağılımı pandemi öncesi ve pandemi dönemleri arasında anlamlı farklılık gösterdi (p<0,001). Antimikrobiyal direnç analizleri en sık izole edilen bakteriyel etkenler için gerçekleştirildi. Pseudomonas spp. izolatlarında direnç oranlarında anlamlı bir değişiklik saptanmadı. Acinetobacter spp. izolatlarında trimetoprim-sülfametoksazol direnci pandemi döneminde anlamlı olarak arttı. Klebsiella spp. izolatlarında trimetoprim-sülfametoksazol G. Kaya et al. Journal of Uludağ University Medical Faculty 52, 1972680, 2026 2 direnci anlamlı olarak arttı. Bu bulgular, COVID-19 pandemi döneminin YBÜ’lerde solunum yolu mikroorganizma dağılımı ve seçilmiş antimikrobiyal direnç paternlerinde değişikliklerle ilişkili olduğunu göstermektedir.

Anahtar Kelimeler

• COVID-19
• yoğun bakım ünitesi
• solunum yolu örnekleri
• antimikrobiyal direnç
• Pseudomonas spp.
• Acinetobacter spp.
• Klebsiella spp.

Destekleyen Kurum

Yoktur

Proje Numarası

no

Etik Beyan

Onay Kurulu: Sakarya Üniversitesi Tıp Fakültesi Girişimsel Olmayan Klinik Araştırma Etik Kurulu Onay Tarihi: 30.01.2024 Karar No: E-71522473/050.01.04-330358-25

Teşekkür

yoktur

Kaynakça

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