Evaluating antibiotic susceptibility trends in S. pneumoniae and H. influenzae isolates during the COVID-19 pandemic: An interrupted time series analysis of a nationwide antimicrobial resistance database

Abstract

Background

The heightened infection prevention measures implemented during the COVID-19 pandemic reduced the incidence of certain other infections; however, the impact of this decrease on antimicrobial susceptibility remains undetermined. Herein, we analyzed data from a large, multicenter, Japanese infectious disease database to evaluate the antibiotic susceptibility trends among bacterial species whose incidence reduced during the COVID-19 pandemic.

Methods

Using a nationwide Japanese AMR database covering hundreds of hospitals, this study applied interrupted time-series analysis to examine level and trend changes in monthly susceptibility rates between the pre-pandemic (January 2018–December 2019) and pandemic (January 2020–March 2023) periods among bacteria whose incidence rates continuously decreased during the COVID-19 pandemic.

Results

Among 2,686,932 isolates of 15 species included during the study period, decreased incidence rates were observed only for H. influenzae (n = 83.376) and S. pneumoniae (n = 72,574). Among H. influenzae and S. pneumoniae, the trend of susceptibility rates for most antibiotics, including penicillins, cephalosporins, carbapenems, fluoroquinolones, and macrolides, did not change during the COVID-19 pandemic. Only the susceptibility of sulbactam/ampicillin for H. influenzae showed an increasing trend of 0.19 % per month (95 % confidence interval [CI]: 0.001, 0.39).

Conclusions

The results of this study were based on data from a large, multicenter database and focused on droplet-transmitted bacteria. We found no susceptibility trend changes during the COVID-19 pandemic. However, the reduced infections observed in the 3-year study period may not be solely responsible for the unchanged susceptibility rates for AMR control. Future studies should explore combined strategies involving reduced infection rates and antimicrobial use to assess bacterial antibiotic susceptibility rates.