Acinetobacter spp. is one of the possible etiological agents of healthcare-associated infections (HAIs), with a high capacity to develop resistance to broad-spectrum antimicrobials. In the context of the COVID-19 pandemic, there was an increase in the demand for patients requiring admission to Intensive Care Units (ICUs) and, consequently, in the use of invasive devices. Such use predisposes to a higher likelihood of HAIs, resulting in indiscriminate use of broad-spectrum antibiotics and potentially leading to changes in the susceptibility profile of nosocomial bacteria, such as Acinetobacter spp. Thus, the objective of this study was to analyze changes in the susceptibility profile of Acinetobacter spp. in patients diagnosed with HAIs before and after the onset of the COVID-19 pandemic. A retrospective study conducted through analysis of data from a tertiary hospital, collected between 2016 and 2023, including information on HAI diagnoses and antimicrobial susceptibility profiles. A total of 276 patients with HAIs caused by Acinetobacter spp. were reported during the study period, 96 before the onset of the COVID-19 pandemic and 180 after. HAI sites were grouped into respiratory tract infections and other sites, and there was a higher occurrence of respiratory tract HAIs caused by Acinetobacter spp. after the onset of the pandemic, compared with other sites, with statistically significant difference (31.2% vs. 46.1%, p = 0.017). The most relevant antibiotics for analysis were selected and classified into resistant and non-resistant strains: amikacin, meropenem, tigecycline, and ampicillin/sulbactam. After the onset of the pandemic, there was an increase in the number of Acinetobacter spp. strains resistant to tigecycline among HAI cases, with statistically significant difference (13.1% vs. 46.8%, p < 0.00001). There was also an increase, after the onset of the pandemic, in the number of strains already resistant to meropenem with a minimum inhibitory concentration (MIC) ≥ 32, which indicates high bacterial resistance, with statistically significant difference (34.2% vs. 84.8%, p < 0.00001). It was possible to observe changes in the HAI profile of the service after the onset of the COVID-19 pandemic, with an increase in respiratory infections caused by Acinetobacter spp., as well as an increase in strains resistant to tigecycline and strains with high resistance to meropenem.
Scarabichi et al. (Sun,) studied this question.