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Impact of the COVID-19 pandemic on the antimicrobial resistance at the General Hospital level in Republic of Srpska, Bosnia and Herzegovina

By
Nasta Manojlović ,
Nasta Manojlović

PHI Hospital “Sveti vračevi” Bijeljina, Bosnia and Herzegovina,

Biljana Mijović ,
Biljana Mijović

Department of Primary Health Care and Public Health, Faculty of Medicine Foča, University of East Sarajevo, Bosnia and Herzegovina, Foča,

Zlatko Maksimović ,
Zlatko Maksimović

PHI Hospital “Sveti vračevi” Bijeljina, Bosnia and Herzegovina,

Dragana Sokolović ,
Dragana Sokolović

Department of pharmacology, Faculty of Medicine Foča, University of East Sarajevo, Bosnia and Herzegovina,

Sanda Lazić ,
Sanda Lazić

PHI Hospital “Svetivračevi” Bijeljina, Bosnia and Herzegovina,

Ljubica Bojanić ,
Ljubica Bojanić

Public Health Institute of the Republic of Srpska, Bosnia and Herzegovina,

Dragana Drakul ,
Dragana Drakul

Department of pharmacology, Faculty of Medicine Foča, University of East Sarajevo, Bosnia and Herzegovina,

Nenad Lalović ,
Nenad Lalović

Department of surgery, Faculty of Medicine Foča, University of East Sarajevo, Bosnia and Herzegovina, University hospital Foča, Republic of Srpska Bosnia and Herzegovina,

Marija Lukić ,
Marija Lukić

University of Belgrade, Faculty of Medicine, Belgrade, Serbia,

Bojan Joksimović
Bojan Joksimović
Contact Bojan Joksimović

Department of preclinical subjects (Pathophysiology), Faculty of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina

Editor: Adrijan Sarajlija

Abstract

Introduction. Antibiotic resistance is a major threat to public health globally. The aim was to examine the impact of the COVID-19 pandemic on the distribution and antimicrobial resistance of pathogenic microorganisms isolated from samples 
obtained during standard hospital care in one hospital center.  
Methods. Data were obtained retrospectively from a database of the hospital microbiology laboratory. Study sample consisted of 3012 samples tested before the pandemic in 2019 and 3130 samples from the pandemic period in 2021. 
Results. There was no statistically significant difference in the occurrence of agents that were resistant to all antibiotics between the observed years, but there was the difference in the occurrence of those agents between departments, with the highest frequency in the intensive care unit and the COVID-19 department (p<0.001). Isolation of Acinetobacter bacteria increased 2.7 times, and Clostridioides difficile 6.4 times during 2021 compared to 2019. Statistically significant differences were registered in resistance to: imipenem, piperacillin-tazobactam, ceftayidime, cefepime, glycopeptides, aminoglycosides, levofloxacin and ciprofloxacin in 2021 compared to 2019. 
Conclusion. Our results suggest possible influence of COVID-19 on antimicrobial resistance and input a need for a new larger study addressing this issue.

Author Contributions

Data curation, N.M., B.M. and M.L.; Funding acquisition, N.M. and Z.M.; Resources, N.M. and Z.M.; Conceptualization, B.M. and N.L.; Formal Analysis, B.M., D.S., S.L. and B.J.; Investigation, B.M., D.S., S.L., D.D., N.L. and M.L.; Supervision, B.M.; Writing – original draft, B.M., D.D. and B.J.; Writing – review & editing, B.M., N.L. and B.J.; Methodology, Z.M., D.S., S.L., L.B. and D.D.; Validation, L.B.; Visualization, L.B. and N.L.; Software, D.D. and M.L. All authors have read and agreed to the published version of the manuscript.

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