Monitoring and features of antibiotic resistance during the COVID-19 pandemic

Abstract

Background. Urinary tract infection (UTI) is an urgent problem in nephrology. The current state of antibiotic resistance to antimicrobial drugs complicates the empirical choice of antibacterial therapy, and indications for the use of antimicrobial drugs are not always clinically justified. The purpose of the study: to compare the antibiotic resistance of the main groups of UTI pathogens during coronavirus 2019 (COVID-19) pandemic in 2020–2022 with the results of 2014–2016 monitoring among children of the Chernivtsi region. Materials and methods. Urine samples were collected from 657 children (0–17 years old) who received specialized medical care in health care institutions of the Chernivtsi region (2014–2016). During 2020–2022, a clinical and laboratory examination of 180 children (0–17 years old) was conducted. ­Results. The results of the monitoring proved the wave-like nature of changes in antibiotic resistance to semi-synthetic penicillins and cephalosporins with the maintenance of a sufficient level of sensitivity to these antimicrobial drugs among the main groups of UTI pathogens; the data obtained give reason to suggest a negative trend to increasing resistance to fluoroquinolones, tetracyclines over time (2020–2022 — the period of the COVID-19 pandemic); a multidirectional and time-dependent differences were revealed in sensitivity to aminoglycosides: gentamicin, amikacin and kanamycin in children of Chernivtsi region, as well as a negative trend to increasing the share of carbapenem-resistant strains of uropathogens — 55.8 ± 5.1 % (imipenem — χ2 = 5.432; p = 0.020). Conclusions. The monitoring results indicate the need to comply with standards in the provision of medical care (prescribing antibacterial therapy taking into account the data of regional monitoring on antibiotic resistance to antimicrobial drugs), administration of antimicrobial drugs in health care institutions that provide medical care in outpatient and inpatient settings. High level of antibiotic resistance of UTI uropathogens to carbapenems (2020–2022), used for the treatment of severe bacterial infections, requires their exclusively targeted prescription in everyday pediatric practice.