| Congresso Brasileiro de Microbiologia 2023 | Resumo: 428-1 | ||||
Resumo:The substantial increase of infections caused by multidrug-resistant pathogens belonging to Enterobacterales order represents a major concern, since they are frequently associated with high mortality rates, longer hospital stay and elevated care costs. Despite of the fact that the COVID-19 pandemic is a viral infection, this event has strongly contributed to the antimicrobial’s direct selective pressure over the microorganisms. Moreover, deadly co-infections caused by pan-resistant bacteria have been reported in COVID-19 patients worldwide. The aims of this study were to analyze comparatively 59 Klebsiella pneumoniae strains isolated from different infection sites in humans, during the pre-pandemic period of 2019 (n=29) and the pandemic period during the years of 2020-2022 (n=30) regarding its antimicrobial resistance. The resistance profiles were obtained by disc diffusion method according to EUCAST/BrCAST guidelines for amikacin (AK), amoxicillin-clavulanate (AMC), ampicillin-sulbactam (SAM), aztreonam (ATM), cefazolin (KZ), ceftriaxone (CRO), ceftazidime (CAZ), cefepime (FEP), cefotaxime (CTX), ciprofloxacin (CIP), chloramphenicol (C), gentamycin (CN), imipenem (IPM), levofloxacin (LEV), meropenem (MEM), nitrofurantoin (NIT), piperacillin-tazobactam (TZP), trimethoprim-sulfamethoxazole (SXT) and tetracycline (TE). In addition, the strains that showed a zone diameter of < 22 mm for CAZ and < 21 mm for CTX or < 23 mm for CRO were selected to the double-disk screening test for ESBL production as recommended by EUCAST. A number of 3 (10.3%) K. pneumoniae pre-pandemic strains and 20 (66.7%) pandemic strains were resistant to all the antimicrobials tested. All the pre-pandemic strains were resistant to AMC, SAM, KZ, CRO, CAZ and FEP and 28 (96.5%) were resistant to ATM, CTX and TZP, 26 (89.6%) to CIP, LEV and SXT, 25 (86.2%) to CN, 22 (75.9%) to IPM and TE, 21 (72.4%) to NIT, 18 (62.1%) to AK, 17 (58.6%) to MEM and 11 (37.9%) to C. In relation to the 30 pandemic strains studied, all of them were resistant to AMC, SAM, KZ and CAZ. Twenty-nine (96.7%) were resistant to ATM, CRO, FEP, CTX, CIP, CN, LEV, SXT and TE, 28 (93.3%) to AK and TZP, 27 (90%) to MEM and NIT, 26 (86.7%) to IPM, and 25 (83.3%) to C. The ESBL production was detected in seven out of 29 (24.1%) pre-pandemic strains compared to five out of 30 (16.7%) pandemic strains. In conclusion, the higher rates of resistance found in the K. pneumoniae pandemic strains studied may suggest that the indiscriminate use of antimicrobials during the COVID-19 pandemic may have increased resistance profiles. Furthermore, the detection of ESBL producing strains is a concern once that the dissemination of resistant determinants has been recognized as a challenge in the treatment of bacterial infections worldwide. Palavras-chave: ESBL, Klebsiella pneumoniae, Pre-pandemic and pandemic period, Resistance profile Agência de fomento:Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP) | |||||