Antibiotic resistance in diabetic foot infection: how it changed with COVID-19 pandemic in a tertiary care center

Aim: To investigate the rate of antibiotic resistance and its main risk factors in a population of patients with diabetic foot infection (DFI) during the COVID-19 pandemic, in comparison with the population of 2019. Methods: Two hundred and twenty-five patients with DFI were admitted in a tertiary care center from January 2019 to December 2020. Antibiotic resistance was evaluated by microbiological examination of soft tissues' or bone's biopsy. Results: Compared with 2019 group (n = 105), 2020 group (n = 120) had a significantly higher prevalence of antibiotic resistance [2019 vs 2020, 36% vs 63%, P <0.001] and more often was admitted with recent or current antibiotic therapy (18% vs 52%, P <0.001), which was frequently self-administered (5% vs 30%, P = 0.032). The risk of antibiotic resistance was also higher in 2020 group [OR 95% CI, 2.90 (1.68 to 4.99)]. Prior hospitalization, antibiotic self administration and antibiotic prescription by general practitioners resulted as independent predictors of antibiotic resistance. Conclusions: In a population of people with DFI admitted in a tertiary care center during the COVID-19 pandemic the prevalence of antibiotic resistance was higher than 2019. Previous hospitalization, antibiotic self-administration /prescription by general practitioners were related to higher risk of antibiotic resistant infections. (c) 2021 Elsevier B.V. All rights reserved.

Automated summary

During the COVID-19 pandemic in 2020, the prevalence of antibiotic resistance in patients with diabetic foot infection was significantly higher compared to 2019, with more patients admitted due to recent or current antibiotic therapy. Various factors such as previous hospitalization, self-administration of antibiotics, and antibiotic prescription by general practitioners were identified as independent predictors of antibiotic resistance.