Antimicrobial stewardship & healthcare epidemiology : ASHE最新文献

{"title":"Effectiveness of fidaxomicin in preventing recurrence after initial community-associated <i>Clostridioides difficile</i> infection.","authors":"Adam Hawco, Christopher Myers, Runda Dahhan, Christine Hurley, Edwin van Wijngaarden, Christina Felsen, Ghinwa Dumyati","doi":"10.1017/ash.2026.10379","DOIUrl":"https://doi.org/10.1017/ash.2026.10379","url":null,"abstract":"<p><p>Using population-based surveillance from 2020 to 2024, we examined recurrence through 180 days among adults with initial community-associated <i>Clostridioides difficile</i> infection (CDI). Fidaxomicin was associated with a 50% lower risk of recurrence compared with vancomycin. These findings are consistent with current guideline recommendations and are relevant to outpatient management of initial CDI.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e117"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing epidemiology and long-term outcomes of patients with CRE infections.","authors":"Sunish Shah, Lloyd G Clarke, Erin K McCreary, Ellen G Kline, Emre Yucel, Alexandre H Watanabe, Ryan K Shields","doi":"10.1017/ash.2026.10348","DOIUrl":"https://doi.org/10.1017/ash.2026.10348","url":null,"abstract":"<p><strong>Background: </strong>The impact of organism species and underlying comorbidities on long-term clinical outcomes for patients with carbapenem-resistant Enterobacterales (CRE) infections is unknown.</p><p><strong>Methods: </strong>Patients with CRE-positive cultures from 2011 to 2019 were monitored for 1-year. Patients without signs of infection were categorized as colonization. Recurrent cases were defined as isolation of the same CRE species >90 days after the index case.</p><p><strong>Results: </strong>720 patients met inclusion criteria and accounted for 749 index cases, which decreased over time. The median (range) age was 61 (20-97) years, 53% (397/749) were male, 20% (151/749) received solid organ transplant (SOT), and 44% resided in the ICU at the time of CRE isolation. The colonization rate was 34% (257/749). Pneumonia and bacteremia represented the most common infection types accounting for 25% (185/749) and 13% (95/749) of all cases, respectively. <i>Klebsiella pneumoniae</i> was most common pathogen (58%), followed by <i>Enterobacter cloacae complex</i> (23%), and <i>Escherichia coli</i> (10%). Of the 554 sequenced isolates, 35% (195/554) were KPC-2, 32% (175/554) KPC-3, and 32% (177/554) non-KPC-producing. This changed over time where KPC-2-producing CRE were most prevalent in 2011, KPC-3 most prevalent between 2015-2017, and non-KPC from 2018-2019. Among 90-day survivors, the CRE recurrence rate was 21% (108/513). Charlson comorbidity index (OR: 1.11; 95% CI: 1.05-1.18; <i>P</i> < .001), isolation of a prior CR pathogen (OR: 2.49; 95% CI 1.32-4.72; <i>P</i> = .005), and ICU admission (OR: 3.35; 95% CI 2.14-5.24; <i>P</i> < .001) were independently associated with 90-day mortality, while SOT was associated with lower 90-day mortality (OR: 0.55; 95% CI 0.32-0.94; <i>P</i> = .029). Overall, 90-day mortality rates were lower among patients with CRE-positive cultures between years 2016 - 2019 (24% [63/262]) compared to years 2011 - 2015 (35.5% [173/487]; <i>P</i> = .001).</p><p><strong>Conclusion: </strong>CRE are increasingly diverse and associated with significant morbidity and healthcare utilization across varying patient groups. Long-term survival of patients infected with CRE has improved over time while overall incidence of CRE has decreased.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e110"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of small hospitals in Japan during the COVID-19 pandemic.","authors":"Chikako Agata, Dang-An Do, Tomoko Yazawa, Yoshiaki Gu","doi":"10.1017/ash.2026.10368","DOIUrl":"https://doi.org/10.1017/ash.2026.10368","url":null,"abstract":"<p><p>An analysis of 630 hospitals and 488 COVID-19 clusters in Tokyo (2020/07-2022/05) found contrasting associations between hospital size and cluster frequency. Compared to larger hospitals (≥600 beds), smaller ones (20-99 beds) reported fewer clusters per facility (0.5 vs 2.0), but a higher cluster number per 1000 beds (6.0 vs 2.5).</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e115"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate antibiotic prescribing for acute respiratory illnesses in outpatient settings in New York City, 2019-2022.","authors":"Celina N Santiago, Katelynn Devinney, Molly M Kratz, Elise Mantell, Elizabeth Cave, Karen A Alroy, William G Greendyke, Nicole Burton","doi":"10.1017/ash.2026.10351","DOIUrl":"https://doi.org/10.1017/ash.2026.10351","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate antibiotic prescribing contributes to antibiotic resistance threats. In outpatient settings, antibiotics are often incorrectly prescribed for acute respiratory illnesses (ARI). Characteristics associated with inappropriate antibiotic prescribing at New York City (NYC) outpatient ARI visits were assessed to identify opportunities for interventions.</p><p><strong>Methods: </strong>Using IQVIA's commercial Medical Claims and Longitudinal Prescription datasets, medical diagnosis codes identified outpatient visits for ARI during 2019-2022, which were linked to antibiotics obtained at a pharmacy (as a proxy for prescribed antibiotics) within 3 days post-visit. Univariate analyses were conducted describing visit, patient, and provider characteristics. Modified Poisson regression with robust error variance was used to calculate unadjusted relative risks (RR) and 95% CI for visit-level characteristics associated with inappropriate prescribing.</p><p><strong>Results: </strong>Among 3,493,444 ARI outpatient visits, 5.1% linked to an inappropriate antibiotic prescription. Among all ARI, bronchitis/bronchiolitis had the highest percentage (25.5% of bronchitis/bronchiolitis visits) and highest risk of inappropriate prescribing relative to asthma/allergy (RR: 18.03; 95% CI: 17.70, 18.38). Adults aged 65-79 years were over twice as likely to be prescribed inappropriate antibiotics relative to children (RR: 2.21; 95% CI: 2.17, 2.25). Inappropriate prescribing was highest in urgent care (8.4%) (RR: 1.25; 95% CI: 1.23, 1.27) relative to offices and among internal medicine physicians (8.0%); relative to these physicians, risk of inappropriate prescribing among all other physician specialties was lower.</p><p><strong>Conclusions: </strong>Inappropriate antibiotic prescribing at ARI outpatient visits was uncommon. Tailoring interventions to providers such as internal medicine physicians or those in urgent care settings may improve prescribing practices.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e116"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncharted territory: assessing antibiotic adverse drug events from walk-in clinics at an academic healthcare system.","authors":"Nishant Patel, Michael Zou, Emily Nardone, Retha Thomas, Angela Zuill, Claude Shackelford, Minhau Zhang, Sharon Onguti, Milner Staub","doi":"10.1017/ash.2026.10356","DOIUrl":"https://doi.org/10.1017/ash.2026.10356","url":null,"abstract":"<p><p>Outpatient antibiotic ADE rates remain poorly defined due to limited tracking methods. We evaluated the use of ICD-10 billing codes, voluntary reporting, and manual review approaches to identify outpatient antibiotic ADEs with variable results. Improved, systematic methods are needed to accurately track antibiotic ADEs and support Antimicrobial Stewardship efforts.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e107"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the infection control team and the infection control environment as perceived among staff nurses in Oman: a nationally based study.","authors":"Omar Al-Rawajfah, Sulaiman Al Sabei, Girija Madhavan Prabhakaran, Frincy Francis, Maryam Alharrasi, Omar AlOmari, Laila Al-Daken, Amal Al-Maani, Ikram Burney, Sathish Kumar Jayapal","doi":"10.1017/ash.2026.10336","DOIUrl":"https://doi.org/10.1017/ash.2026.10336","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess staff nurses' perceptions of the infection control team's (ICT) role and the infection control environment across healthcare settings in the Sultanate of Oman.</p><p><strong>Design: </strong>A descriptive cross-sectional design was employed.</p><p><strong>Participants: </strong>Data were collected from 997 staff nurses working in 18 public and private tertiary hospitals across 10 governorates in Oman.</p><p><strong>Methods: </strong>Participants completed self-reported questionnaires measuring the perceived role of the ICT (PRICT) and the perceived infection control environment (PICE).</p><p><strong>Results: </strong>The mean PRICT score was 64.7 (SD = 9.4), indicating basic perceived ICT competence, while the mean PICE score was 56.1 (SD = 12.1), reflecting an acceptable infection-control environment. Hospital affiliation, accreditation status, and availability of an infection control manual significantly predicted PRICT. PRICT was moderately correlated with PICE (<i>r</i> = 0.50, <i>p</i><.001). Nurses in private and accredited hospitals reported higher PRICT and PICE scores.</p><p><strong>Conclusion: </strong>The findings underscore the significance of consistent infection control team practices, effective communication, hospital accreditation, and accessible infection control manuals. Strengthening ICT roles through structured interdisciplinary collaboration and standardized programs may enhance infection control practices and patient safety in Omani hospitals and support quality improvement initiatives nationwide across healthcare sectors and inform infection control policy development.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e108"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of outpatient parenteral antibiotic therapy: a United States-based multi-center survey.","authors":"Laila M Castellino, Christina G Rivera, Susan E Beekmann, Philip M Polgreen, Monica M Mahoney, Sara C Keller","doi":"10.1017/ash.2026.10347","DOIUrl":"https://doi.org/10.1017/ash.2026.10347","url":null,"abstract":"<p><strong>Objective: </strong>Outpatient parenteral antimicrobial therapy (OPAT) programs continue to evolve with increases in multidisciplinary teams, complex oral antibiotics, long-acting injectable antimicrobials, patients with substance use disorder (SUD) and telehealth. We sought to examine how OPAT programs are currently structured and identify barriers to safe care.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Participants: </strong>Physician, pharmacist, and advanced practice providers (APP) Emerging Infections Network (EIN) members.</p><p><strong>Methods: </strong>A survey was conducted between February and March 2025 to assess OPAT structure, expansion to complex outpatient antimicrobial therapy (COpAT), and barriers to safe OPAT care.</p><p><strong>Results: </strong>Of 1639 EIN members, 622 (38%) responded; 75% reported an active role in OPAT. Oversight of patients on COpAT was reported by 59%, and mandatory ID consultation for OPAT by 59%. Eighty-one percent reported >75% of OPAT patients were followed by ID. Most patients received OPAT at home (78%) followed by post-acute care facilities. Outpatient and inpatient ID physicians were responsible for laboratory test monitoring (75% and 30% respectively), while 37% reported a multidisciplinary OPAT team and 32% reported non-specialists. Respondents cited inadequate support in data analysis, administration, information technology and financial support for clinical staff. Common challenges were lack of leadership awareness (51%), difficulty managing patients with SUD (50%) and timely access to laboratory test results (48%).</p><p><strong>Conclusions: </strong>ID physicians were commonly involved in OPAT care, with many programs expanding to COpAT. Several barriers to the safe delivery of OPAT remain, including lack of institutional support, reimbursement and poor communication between stakeholders.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e109"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and outcomes for colonization of multidrug-resistance organisms (MDROs) among patients undergoing elective orthopedic surgery.","authors":"Sirikwun Umpunthongsiri, Anucha Apisarnthanarak, Potjanee Srimanote, Thana Khawcharoenporn, Chayanin Aungthong, Narissara Mungkornkaew, Pansachee Damronglerd, Sasinuch Rutjanawech, Nuntra Suwantarat","doi":"10.1017/ash.2026.10354","DOIUrl":"https://doi.org/10.1017/ash.2026.10354","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incidence, risk factors, and outcomes associated with multidrug-resistant organisms (MDROs) colonization in patients undergoing elective orthopedic surgery at the Thammasat University Hospital.</p><p><strong>Methods: </strong>We conducted a prospective MDROs surveillance screening (swabs from the nose, throat, groin, and rectum) in patients undergoing orthopedic surgery. MDROs were defined as extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacteria (GNB), carbapenem-resistant <i>Enterobacterales</i>, methicillin-resistant <i>Staphylococcus aureus</i>, and vancomycin-resistant enterococci. The incidence of MDROs colonization, risk factors, and outcomes including surgical site infections (SSIs) were assessed. Postoperative SSIs were compared between patients with and without MDROs colonization.</p><p><strong>Results: </strong>Of 384 swabs tested from 96 patients, ESBL-producing <i>Escherichia coli</i> was identified in 38 isolates (31 rectal swabs and 7 groin swabs) from 31 patients (32.3%). Only one patient had a history of admission within the previous year. Majority of procedures involved prosthetic implantation (77.1%) including total knee arthroplasty (30.2%). Seven patients (7.3%) developed SSIs without microbiological confirmation. The incidence of SSIs was higher among patients with ESBL-producing <i>E. coli</i> colonization compared to patients without colonization (6/31, 19.4% vs. 1/65, 1.5%; <i>P</i> = .004; odds ratio, 15.36; 95% CI 1.7-356.3). From the multivariate logistic regression analysis, preoperative ESBL-producing <i>E. coli</i> colonization was associated with SSIs (<i>P</i> = .014, adjusted odds ratio 16.53, 95% CI 1.78-153.44).</p><p><strong>Conclusion: </strong>Preoperative ESBL-producing <i>E. coli</i> colonization was common among patients undergoing orthopedic surgery and possibly increased risk of SSIs. Further studies for multidrug-resistant GNB screening, surgical outcomes, and antibiotic prophylaxis modification should be considered in endemic regions.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e106"},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of incorporating electronic medical record tools on optimal antibiotic durations at discharge for uncomplicated community-acquired pneumonia: a quasi-experimental study.","authors":"Merin Babu, Amy E Beaulac, Janeen Dubay, Lori Leman, Anita B Shallal, Rachel M Kenney, Brian M Church, Robert McCollom, Michael P Veve, Sage B Greenlee","doi":"10.1017/ash.2026.10326","DOIUrl":"https://doi.org/10.1017/ash.2026.10326","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of electronic medical record (EMR) transitions of care tools on antibiotic durations for uncomplicated community-acquired pneumonia (CAP).</p><p><strong>Design: </strong>IRB-approved, quasi-experiment.</p><p><strong>Setting: </strong>Five acute-care hospitals in Michigan.</p><p><strong>Patients: </strong>Hospitalized adults with uncomplicated CAP between 07/01/2023 and 11/30/2023 (pre-intervention) and 07/01/2024 and 11/30/2024 (post-intervention) were included. Patients were excluded if antibiotics were completed prior to discharge date, admitted to intensive care unit, respiratory culture with methicillin-resistant <i>Staphylococcus aureus</i> or <i>Pseudomonas aeruginosa</i> ≤12-months before admission, suspected concomitant infection, or complicated CAP.</p><p><strong>Methods: </strong>EMR tools implemented March-May 2024 included a total antibiotic days counter and an inpatient stop date carryover on discharge order. The primary outcome was the proportion of patients prescribed ≤6-calendar-days of therapy. Secondary outcomes included 30-day CAP-related readmission, <i>Clostridioides difficile</i> infection (CDI), multidrug-resistant organisms (MDRO) ≤90-days of discharge, and days of therapy prescribed at discharge.</p><p><strong>Results: </strong>234 patients were included: 124 pre- and 110 post-intervention. A higher proportion of post-intervention patients received ≤6-days of therapy (54% pre- vs 72.7% post-intervention, <i>P</i> = 0.003). No notable differences were seen in CDI or MDROs. Pre-intervention patients experienced more CAP-related readmissions (12.1% pre- vs. 4.5% post-intervention, <i>P</i> = 0.039) and more days of therapy at discharge [3-d (IQR 2-4) pre- vs. 2-d (IQR 1-4) post-intervention, <i>P</i> < 0.001]. After adjustment for confounders, the post-intervention group had 2-fold increased odds of receiving ≤ 6-days of therapy for CAP (adjOR, 2.27; 95%CI, 1.31-3.93).</p><p><strong>Conclusion: </strong>Implementation of EMR transitions of care tools significantly improved antibiotic durations in hospitalized adults with CAP, without negatively impacting patient outcomes.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e100"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial resistance before and after the COVID-19 pandemic in Northern Brazil.","authors":"José Eudes de Carvalho Neri, Julius Caesar Mendes Soares Monteiro, Lorena Luciane Martins Rodrigues, Edgar de Brito Sobrinho, Cristiane Guimarães Monte, Ana Carolina Paes Boulhosa, Rafaela Caroline Amador Ferreira, Rita Catarina Medeiros Sousa","doi":"10.1017/ash.2026.10341","DOIUrl":"https://doi.org/10.1017/ash.2026.10341","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the impact of the COVID-19 pandemic on the profile of bacterial resistance in healthcare-associated lower respiratory tract infections (HAI/LRTI), in an intensive care unit.</p><p><strong>Setting: </strong>City of Belém-PA.</p><p><strong>Design: </strong>This is a retrospective and analytical cross-sectional study, in which the resistance profile of HAI/LRTI bacterial isolates was evaluated over 2018-2022.</p><p><strong>Results: </strong>The review of HAI notifications revealed 330 lower respiratory tract infections during the study period. The bacteria with a significant change in the resistance profile between the period pre-COVID and the post-COVID periods were <i>P. aeruginosa</i> (<i>P</i> = .011), <i>K. pneumoniae</i> (<i>P</i> < .001) and <i>A. baumannii</i> (<i>P</i> = .001), with increased profiles multidrug-resistant, and extensively drug-resistant, and strains with pandrug-resistant profile, in 2020 and 2021. In the analysis by antibiotic class, there was a significant increase in <i>A. baumannii</i> resistance to carbapenems and <i>K. pneumoniae</i> resistance to carbapenems.</p><p><strong>Conclusions: </strong>Comparing the periods, there was an emergence of <i>K. pneumoniae</i> resistant to aminoglycosides and carbapenems; of <i>P. aeruginosa</i> with tendency to resistance to aminoglycoside, carbapenem, 4th generation cephalosporin and anti-pseudomonal penicillin + beta-lactamase inhibitor; of <i>A. baumannii</i> resistant to aminoglycoside, carbapenem, quinolone, anti-pseudomonal penicillin + beta-lactamase inhibitor and penicillin + beta-lactamase inhibitor and 4th generation cephalosporin.</p>","PeriodicalId":72246,"journal":{"name":"Antimicrobial stewardship & healthcare epidemiology : ASHE","volume":"6 1","pages":"e102"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}