Antimicrobial resistance before and after the COVID-19 pandemic in Northern Brazil

Abstract Objective: 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. Setting: City of Belém-PA. Design: This is a retrospective and analytical cross-sectional study, in which the resistance profile of HAI/LRTI bacterial isolates was evaluated over 2018–2022. Results: 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 P. aeruginosa ( P = .011), K. pneumoniae ( P < .001) and A. baumannii ( P = .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 A. baumannii resistance to carbapenems and K. pneumoniae resistance to carbapenems. Conclusions: Comparing the periods, there was an emergence of K. pneumoniae resistant to aminoglycosides and carbapenems; of P. aeruginosa with tendency to resistance to aminoglycoside, carbapenem, 4th generation cephalosporin and anti-pseudomonal penicillin + beta-lactamase inhibitor; of A. baumannii resistant to aminoglycoside, carbapenem, quinolone, anti-pseudomonal penicillin + beta-lactamase inhibitor and penicillin + beta-lactamase inhibitor and 4th generation cephalosporin.