Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network

<b><i>Aim:</i></b> This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic in Mexico. <b><i>Methods:</i></b> We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic). <b><i>Results:</i></b> In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (<i>p</i> ≤ 0.01) was detected for <i>Staphylococcus aureus</i>, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (<i>p</i> ≤ 0.01), for <i>Klebsiella pneumoniae</i>. In all specimens, increased ampicillin and tetracycline resistance was detected for <i>Enterococcus faecium</i> (<i>p</i> ≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (<i>p</i> ≤ 0.01), resistance was detected for <i>Escherichia coli</i>; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (<i>p</i> ≤ 0.01), resistance was detected for <i>Pseudomonas aeruginosa</i>. <b><i>Conclusion:</i></b> Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for <i>S. aureus</i> and carbapenem resistance for <i>K. pneumoniae</i> recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in <i>S. aureus</i> was detected, which may be associated with high azithromycin use. In general, for <i>Acinetobacter baumannii</i> and <i>P. aeruginosa</i>, increasing resistance rates were detected.