Shifting Trends of Antimicrobial Resistance Patterns Among Uropathogenic Bacteria Before and During the COVID-19 Pandemic

Urinary tract infections (UTIs) represent a significant global health concern, primarily caused by uropathogenic bacteria and their rising trend of antimicrobial resistance (AMR). This study investigates the prevalence and pattern of AMR among uropathogenic bacteria during the COVID-19 pandemic, highlighting its impact on antimicrobial usage and resistance trends. This retrospective cross-sectional study, conducted at King Fahad Medical City, Riyadh, Saudi Arabia, from January 1, 2018, to December 31, 2022, analyzed 10,031 patients with positive urine cultures for resistance patterns pre-COVID-19 and during COVID-19. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix system according to Clinical Laboratory Standard Institute guidelines. This study recorded an overall decrease in AMR during the pandemic among the most prevalent uropathogens (<i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, and <i>Pseudomonas aeruginosa</i>); however, notable increases in AMR were observed for specific antibiotics like cefoxitin, imipenem, and colistin. resistance. The multidrug resistance (MDR) among <i>P. aeruginosa</i> strains significantly decreased from 22.9% pre-pandemic to 9.2% during the pandemic. The decline in AMR patterns during the COVID-19 pandemic likely resulted from altered antibiotic usage and healthcare practices, emphasizing the importance of ongoing monitoring and targeted antimicrobial management in response to changing AMR dynamics during global health emergencies.