Antibiogram at a Rural Hospital Against the Background of COVID-19: A Five-Year Retrospective Review.

Autor:	Okobi OE; Family Medicine, Lakeside Medical Center, Belle Glade, USA., Evbayekha EO; Internal Medicine, St. Luke's Hospital, St. Louis, USA., Shittu HO; Internal Medicine, Federal Medical Centre, Abeokuta, NGA., Arinze IE; Internal Medicine, Weiss Memorial Hospital, Chicago, USA., Nnaji CG; Internal Medicine/Family Medicine, Windsor University School of Medicine, Chicago, USA., Umeh NJ; General Medicine, Brooklyn Queens Nursing Home, New York, USA., Ajayi TO; Internal Medicine, University at Buffalo, New York, USA., Ajayi OO; Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, NGA., Ayisire OE; Psychiatry, University of South Wales, Pontypridd, GBR., Dick AI; Public Health, Chicago State University, Chicago, USA., Agazie O; General Medicine, College of Medicine, University of Lagos, Idi Araba, NGA., Igweike C; Preventive Medicine, RBH Medical Center, Richmond, USA., Ekpemiro CU; Surgery, Federal Medical Centre, Umuahia, NGA., Jacks BE; Surgery, University of Maiduguri Teaching Hospital, Maiduguri, NGA., Onyechi NP; Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Jul 25; Vol. 14 (7), pp. e27221. Date of Electronic Publication: 2022 Jul 25 (Print Publication: 2022).
DOI:	10.7759/cureus.27221
Abstrakt:	Background and objective The role of the antibiogram in reducing hospital length of stay (LOS), mortality rate, health care costs, and, by extension, patients' social, physical, and emotional wellness has a significant impact on the medical community. Hospitals in large cities serve a dynamic population of diverse ethnic groups. Many scholarly works and publications have shown that the antimicrobial pattern in rural settings has significant variability annually. Over the last two years, the spread of coronavirus disease 2019 (COVID-19) has brought about many unknowns in the sphere of healthcare. The pattern of pathology accompanying COVID-19 has affected hospital policies and direct patient management, leading to a paradigm shift in approaches, policies, and resource utilization. The years 2019 to 2021 were marked by many admissions due to COVID-19, and the effects of COVID-19 are still being studied. In light of this, this study examined the changes in sensitivity patterns, new trends, and nature of bacteria isolates, antimicrobial rates, and susceptibility based on a rural hospital's annual antibiogram pertaining to its central departments: the intensive care unit (ICU), patient care unit (PCU), the outpatient unit, and emergency department (ED). Methods This five-year retrospective antibiogram review compared antibiogram patterns two years before the first case of COVID-19 was reported in the hospital and those two years after the initial outbreak. Results The organism comparative susceptibility tests for Escherichia coli (E. coli) were not significant except for increased susceptibility toward nitrofurantoin (p=0.003); Klebsiella pneumoniae ( K. pneumoniae) was also not significant except for the increased susceptibility to ciprofloxacin (p=0.003). Pseudomonas aeruginosa (P. aeruginosa) had no changes in susceptibility patterns, while Proteus mirabilis (P. mirabilis)  had increased susceptibility to imipenem (p=0.05), aztreonam (p=0.00), and meropenem (p=0.004), with reduced susceptibility to gentamicin (97.47% vs. 88.24%, p=0.006). There was a whopping decrease in the sensitivity of methicillin-resistant  Staphylococcus aureus  (MRSA) to clindamycin (75.93% vs. 50.7%, p=0.000), linezolid (99.54% vs. 88.73, p=0.004), trimethoprim/sulfamethoxazole (92.59% vs. 74.65%, p=0.001), and vancomycin (99.54% vs. 88.73%, p=0.004). Staphylococcus aureus (S. aureus) had no significant variation except an increase in susceptibility to nitrofurantoin (p=0.023), and perhaps ironically, Streptococcus pneumoniae (S. pneumoniae) had no significant changes in susceptibility pattern. Conclusion Our data demonstrate that the susceptibility of different drugs against different bacterial pathogens varied. However, some antibiotic drugs were found to have high susceptibility against different isolated organisms, and these drugs include amikacin, levofloxacin, vancomycin, cefotaxime, nitrofurantoin, and ceftriaxone. Some organisms showed a significantly declined antibiotic susceptibility, while others showed a significant improvement. The role of COVID-19 regarding these changes is unknown. COVID-19 may not be the cause of the observed differences. We believe that further research on antibiotic legislation and prescribing trends is required. Other non-significant study findings may be attributed to the limited data available to us. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Okobi et al.)
Databáze:	MEDLINE
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