Trend analysis of carbapenem-resistant Gram-negative bacteria and antimicrobial consumption in the post- COVID-19 era: an extra challenge for healthcare institutions

The incidence density trend of the carbapenem-resistant Gram-negative bacteria was analysed in device-associated infections and antimicrobial consumption in 99 critical care facilities in a low/middle-income country, between January 2019 and December 2020. Carbapenem-resistant Acinetobacter baumannii (CRAB) per 1000 patient-days increased in 2020 and this finding had a strong positive correlation with the incidence density of COVID-19 by the Spearman test. Polymyxin consumption also increased in 2020 but without significant correlation with CRAB or COVID-19 incidence density, presumably due to empirical and untargeted prescribing as a consequence of concern about CRAB infections. These findings are a warning to infection control programmes and antimicrobial stewardship. (c) 2021 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study analyzed the incidence density trend of carbapenem-resistant Gram-negative bacteria and antimicrobial consumption in 99 critical care facilities in a low/middle-income country. The findings showed an increase in the incidence density of carbapenem-resistant Acinetobacter baumannii (CRAB) in 2020, which was strongly correlated with the incidence density of COVID-19. There was also an increase in polymyxin consumption in 2020, but it was not significantly correlated with CRAB or COVID-19 incidence density, likely due to empirical and untargeted prescribing.