After the COVID-19 pandemic, a significant increase in multidrug-resistant pathogens ‒ such as Acinetobacter spp., Enterobacter spp., Escherichia spp., Klebsiella spp., Providencia spp., Pseudomonas spp., and Serratia spp. ‒ was observed in Minas Gerais, Brazil. Disparities in access to diagnostic services among microregions worsened the problem, while indiscriminate antimicrobial use, particularly to treat COVID-19 ‒ associated pneumonia, contributed to the spread of resistance genes. To analyze and compare the genotypic profile of hospital bacterial resistance before and during the post-COVID-19 period in Minas Gerais, Brazil, highlighting possible changes and impacts resulting from disruption of diagnostic and control services during the pandemic. Cross-sectional, retrospective, descriptive study analyzing 13,012 Gram-negative bacterial isolates from hospitals in Minas Gerais between 2016 and 2022. Samples (urine, tracheal secretion, blood, and surgical wound exudate) were sent to the laboratory based on phenotypic resistance profiles detected in antibiograms. Genotypic analysis used PCR to detect resistance genes (blaKPC, blaOXA, blaNDM, blaSPM, blaVIM, and blaIMP), with the presence of at least one gene indicating multidrug resistance. Data were categorized into three periods (pre-pandemic, pandemic, and post-pandemic). Statistical analysis used descriptive statistics, univariate tests, and chi-square testing (p<0.05). Analysis of 13,012 Gram-negative bacterial samples showed notable shifts in resistance gene patterns across the pre-, during-, and post-COVID-19 periods. Although blaKPC became proportionally less prevalent, its total number increased after the pandemic. blaOXA and blaNDM increased significantly, suggesting dissemination of new resistant strains. The mcr1 gene, associated with colistin resistance, appeared in four post-pandemic cases. The rise in antimicrobial resistance after the pandemic underscores the urgent need to strengthen surveillance systems, expand access to molecular diagnostics, and review antimicrobial prescribing policies.
Pereira et al. (Sun,) studied this question.