Observational studyAnnals of clinical microbiology and antimicrobials2021
Antimicrobial susceptibility patterns of respiratory Gram-negative bacterial isolates from COVID-19 patients in Switzerland.
Observational study in Annals of clinical microbiology and antimicrobials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Worldwide threatening prevalence of carbapenem-resistantEpidemiology and infection · 2025Pooled it
- Pooled it
- Antibiotic Resistance during COVID-19: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Clinical characteristics and temporal trends of meropenem and piperacillin/tazobactam heteroresistance in Pseudomonas aeruginosa isolates.Annals of clinical microbiology and antimicrobials · 2026Article
- Resistance to Plazomicin: An Analysis of the Evidence from In Vitro Antimicrobial Susceptibility Studies.Antibiotics (Basel, Switzerland) · 2026Review
- Prevalence of respiratory viruses and nasal colonization by antimicrobial-resistant bacteria among people living with HIV in Ghana.BMC infectious diseases · 2026Article
- Review
- Review
- Early Bacterial Coinfections in Patients Admitted to the ICU With COVID-19 or Influenza: A Retrospective Cohort Study.Critical care explorations · 2023Article
- The under investigated facet of the COVID-19 pandemic: Molecular analysis of secondary bacterial infections at a COVID dedicated intensive care unit within a tertiary care center in Lebanon.Frontiers in medicine · 2023Article
- Resistance Transition ofInfection and drug resistance · 2023Article
- The impact of COVID-19 on antimicrobial prescription and drug resistance in fungi and bacteria.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2022Article
- Pseudomonas aeruginosa modulates alginate biosynthesis and type VI secretion system in two critically ill COVID-19 patients.Cell & bioscience · 2022Article
- The rise in antimicrobial resistance: An obscure issue in COVID-19 treatment.PLOS global public health · 2022Article
- The Complexity of Co-Infections in the Era of COVID-19.SN comprehensive clinical medicine · 2021Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundBacterial superinfections associated with COVID-19 are common in ventilated ICU patients and impact morbidity and lethality. However, the contribution of antimicrobial resistance to the manifestation of bacterial infections in these patients has yet to be elucidated.
methodsWe collected 70 Gram-negative bacterial strains, isolated from the lower respiratory tract of ventilated COVID-19 patients in Zurich, Switzerland between March and May 2020. Species identification was performed using MALDI-TOF; antibiotic susceptibility profiles were determined by EUCAST disk diffusion and CLSI broth microdilution assays. Selected Pseudomonas aeruginosa isolates were analyzed by whole-genome sequencing.
resultsPseudomonas aeruginosa (46%) and Enterobacterales (36%) comprised the two largest etiologic groups. Drug resistance in P. aeruginosa isolates was high for piperacillin/tazobactam (65.6%), cefepime (56.3%), ceftazidime (46.9%) and meropenem (50.0%). Enterobacterales isolates showed slightly lower levels of resistance to piperacillin/tazobactam (32%), ceftriaxone (32%), and ceftazidime (36%). All P. aeruginosa isolates and 96% of Enterobacterales isolates were susceptible to aminoglycosides, with apramycin found to provide best-in-class coverage. Genotypic analysis of consecutive P. aeruginosa isolates in one patient revealed a frameshift mutation in the transcriptional regulator nalC that coincided with a phenotypic shift in susceptibility to β-lactams and quinolones.
conclusionsConsiderable levels of antimicrobial resistance may have contributed to the manifestation of bacterial superinfections in ventilated COVID-19 patients, and may in some cases mandate consecutive adaptation of antibiotic therapy. High susceptibility to amikacin and apramycin suggests that aminoglycosides may remain an effective second-line treatment of ventilator-associated bacterial pneumonia, provided efficacious drug exposure in lungs can be achieved.
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