Frequency of Enterobacteriaceae in blood cultures andantibiotic resistance pattern in pre-COVID and during COVID period

Background and Aim : Bacterial co-pathogens are commonly identified in viral respiratoryinfections and are important causes of morbidity and mortality especially in bacteremia orsepticemia. We attempted to observe whether COVID-۱۹ infection and antibiotics use in COVIDperiod had an effect in bacterial frequency as well as antibiotic resistance pattern.Methods : This retrospective study was carried out from January ۲۰۱۹ to July ۲۰۲۲. Patients andmicrobiological records were studied and analyzed for the presence of bacterial agents and theirantibiotic susceptibility pattern.Results : Year ۲۰۱۹, the period before COVID emergence, observed E.coli and Klebsiellapneumoniae as the predominant species isolated predominantly from internal ward. In terms ofantibiotic resistance pattern, ۲۷.۳% E. coli isolates were sensitive to all antibiotics, ۴.۶% were onlyresistant to cefotaxime, ۶۳.۷% were simultaneously resistant to cefotaxime and ceftazidime, and۴.۵% had simultaneous resistance to cefotaxime, ceftazidime and amikacin. Similarly, ۲۶.۳%K.pneumoniae isolates were sensitive to all antibiotics however, ۲.۶% were resistant only toceftazidime, ۵۰.۱% were simultaneously resistant to cefotaxime and ceftazidime, ۲۱% weresimultaneously resistant to cefotaxime, ceftazidime and amikacin and ۱۸.۴% isolates were panresistant. Year ۲۰۲۰, the early COVID period, observed the same bacterial isolates with similarresistance pattern. In contrast to E.coli, K. pneumoniae frequency increased in COVID patientsadmitted wards. Year ۲۰۲۱- Though the bacterial organisms were similar however, susceptibilityof E.coli decreased from ۲۷.۳% to ۱۲.۵% and increased ESBL producing E.coli. Frequency ofK.pneumoniae decreased to only ۳ bacterial isolates. Year ۲۰۲۲- the lowest prevalence of COVIDperiod, until July, only ۲۰% E. coli isolates retained antibiotic susceptibility, ۲۰% were resistantto cefotaxime, ۱۰% were resistant to ceftazidime, and ۵۰% were simultaneously resistant tocefotaxime and ceftazidime. K. pneumoniae showed increase in the antibiotic resistance with۳۳.۳% isolates revealing simultaneous resistance to cefotaxime, ceftazidime and amikacin.Conclusion : E.coli and K.pneumoniae were the two co-infectious agents in bacteremic orsepticemia patients with COVID-۱۹. Co-infection with other Enterobacteriaceae agent wasrelatively infrequent. The investigation did not observed much difference in bacterial co-pathogensin COVID or non-COVID period. However, increase in antibiotic resistance especially ESBLproduction was evident in these years.

کلیدواژه ها:

COVID-۱۹ ، Bacterial infection ، E.coli ، Klebsiella pneumoniae ، Blood infection ، Copathogens