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Polemis M, Mandilara G, Pappa O, Argyropoulou A, Perivolioti E, Koudoumnakis N, Pournaras S, Vasilakopoulou A, Vourli S, Katsifa H, Karampatakis T, Papavasiliou A, Petinaki E, Xitsas S, Skoura L, Protonotariou E, Mantzana P, Gartzonika K, Priavali E, Kallinteri A, Giannopoulou P, Charalampaki N, Memezas M, Calina Oana Z, Papadogianni M, Panopoulou M, Koutsidou A, Vatopoulos A, Tryfinopoulou K. COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance-WHONET-Greece (January 2018-March 2021). Life (Basel) 2021; 11:996. [PMID: 34685368 PMCID: PMC8538738 DOI: 10.3390/life11100996] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022] Open
Abstract
Changes in hospitals' daily practice due to COVID-19 pandemic may have an impact on antimicrobial resistance (AMR). We aimed to assess this possible impact as captured by the Greek Electronic System for the Surveillance of Antimicrobial Resistance (WHONET-Greece). Routine susceptibility data of 17,837 Gram-negative and Gram-positive bacterial isolates from blood and respiratory specimens of hospitalized patients in nine COVID-19 tertiary hospitals were used in order to identify potential differences in AMR trends in the last three years, divided into two periods, January 2018-March 2020 and April 2020-March 2021. Interrupted time-series analysis was used to evaluate differences in the trends of non-susceptibility before and after the changes due to COVID-19. We found significant differences in the slope of non-susceptibility trends of Acinetobacter baumannii blood and respiratory isolates to amikacin, tigecycline and colistin; of Klebsiella pneumoniae blood and respiratory isolates to meropenem and tigecycline; and of Pseudomonas aeruginosa respiratory isolates to imipenem, meropenem and levofloxacin. Additionally, we found significant differences in the slope of non-susceptibility trends of Staphylococcus aureus isolates to oxacillin and of Enterococcus faecium isolates to glycopeptides. Assessing in this early stage, through surveillance of routine laboratory data, the way a new global threat like COVID-19 could affect an already ongoing pandemic like AMR provides useful information for prompt action.
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Affiliation(s)
- Michalis Polemis
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
| | - Georgia Mandilara
- School of Public Health, University of West Attica, 11521 Athens, Greece; (G.M.); (A.V.)
| | - Olga Pappa
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
| | - Athina Argyropoulou
- “Evaggelismos” General Hospital, 10676 Athens, Greece; (A.A.); (E.P.); (N.K.)
| | | | | | - Spyros Pournaras
- “Attikon” University Hospital, 12462 Athens, Greece; (S.P.); (A.V.); (S.V.)
| | | | - Sophia Vourli
- “Attikon” University Hospital, 12462 Athens, Greece; (S.P.); (A.V.); (S.V.)
| | - Helen Katsifa
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Theodoros Karampatakis
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Anastasia Papavasiliou
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Efthymia Petinaki
- University Hospital of Larissa, 41110 Larissa, Greece; (E.P.); (S.X.)
| | - Stylianos Xitsas
- University Hospital of Larissa, 41110 Larissa, Greece; (E.P.); (S.X.)
| | - Lemonia Skoura
- “Axepa” University Hospital, 54636 Thessaloniki, Greece; (L.S.); (E.P.); (P.M.)
| | | | - Paraskevi Mantzana
- “Axepa” University Hospital, 54636 Thessaloniki, Greece; (L.S.); (E.P.); (P.M.)
| | | | - Efthalia Priavali
- University Hospital of Ioannina, 45500 Ioannina, Greece; (K.G.); (E.P.); (A.K.)
| | - Amalia Kallinteri
- University Hospital of Ioannina, 45500 Ioannina, Greece; (K.G.); (E.P.); (A.K.)
| | | | | | - Meletis Memezas
- “Thriasio” General Hospital of Elefsina, 19600 Athens, Greece; (P.G.); (N.C.); (M.M.)
| | - Zervaki Calina Oana
- “St. George” General Hospital, 73300 Crete (Chania), Greece; (Z.C.O.); (M.P.)
| | - Marina Papadogianni
- “St. George” General Hospital, 73300 Crete (Chania), Greece; (Z.C.O.); (M.P.)
| | - Maria Panopoulou
- University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece; (M.P.); (A.K.)
| | - Athanasia Koutsidou
- University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece; (M.P.); (A.K.)
| | - Alkiviadis Vatopoulos
- School of Public Health, University of West Attica, 11521 Athens, Greece; (G.M.); (A.V.)
| | - Kyriaki Tryfinopoulou
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
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