Resistance Transition of Pseudomonas aeruginosa in SARS-CoV-2-Uninfected Hospitalized Patients in the Pandemic

Abstract

Objective

To investigate the impact of coronavirus disease 2019 (COVID-19) specified preventive and control measures on the distribution and resistance transition of Pseudomonas aeruginosa (P. aeruginosa) in uninfected hospitalized patients during the pandemic.

Methods

This retrospective study retrieved data from 316 P. aeruginosa isolates in the year pre-COVID-19 (n=131) pandemic and the year under COVID-19 specified preventive and control (post-pandemic year, n=185), compared the general characteristics, laboratory results, and antimicrobial susceptibility tests of P. aeruginosa between the two groups.

Results

Compared with the pre-pandemic year, the isolation rate of P. aeruginosa (14.35% vs 22.31%, P<0.001) increased, while the rate of drug resistant P. aeruginosa decreased significantly (29.77% vs 19.45%, P<0.001) in the post-pandemic year; Prescription of β-Lactams (30.5% vs 50.0%, P<0.01) also increased significantly. The resistance rates of P. aeruginosa isolates to ceftazidime (P<0.01), ciprofloxacin (P<0.01), and gentamicin (P<0.001) increased, whereas the resistance rates to piperacillin/tazobactam (P<0.01) and imipenem (P<0.05) decreased significantly.

Conclusion

The COVID-19 specified preventive and control measures have influenced the distribution and resistance transition of P. aeruginosa, further verifications are needed in future research.

Keywords:

• COVID-19
• Pseudomonas aeruginosa
• isolation rate
• drug resistance

Abbreviations

A. baumannii, Acinetobacter baumannii; AMR, antimicrobial resistance; CHA, Chinese Hospital Association; CLSI, Clinical and Laboratory Standards Institute; COVID-19, coronavirus disease 2019; CPMA, Chinese Preventive Medicine Association; E. coli, Escherichia coli; K. pneumoniae, Klebsiella pneumoniae; MIC, minimal inhibitory concentration; P. aeruginosa, Pseudomonas aeruginosa.

Data Sharing Statement

All the findings are available from the corresponding author upon request. All relevant data have been included in the manuscript.

Ethics Approval and Consent to Participate

This study was conducted in accordance with the declaration of Helsinki of the World Medical Congress and the Measures for Ethical Review of Biomedical Research Involving Human Beings issued by the National Health and Family Planning Commission of the People’s Republic of China. This study was approved by the Affiliated Hospital of Chengdu University (NO. PJ-2020-021-03 (2nd version updated at January 9, 2023)). The research only uses the previous medical record information and has removed the relevant personal information of the subject, which will not cause risks to the subject and will not have adverse effects on the rights and health of the subject, so the requirement for informed consent was waived owing to the retrospective nature of the study. We will make every effort to protect the privacy and personal information of the subject’s personal medical data within the scope permitted by law.

Acknowledgments

The authors gratefully acknowledge Dr. Yamei Zhang for her constructive comments and assistance during the review response process of this paper.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research was funded by the Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province (ARRLKF21-06), the Research Project of Sichuan Medical Association (No. S21055), the Educational Reform Research Projects of Chengdu University (CDJGB2019088 and DJGB2019100), and the Innovation Foundation of The Affiliated Hospital of Chengdu University (No. CDFYCX202209).