Study by the D’Or Institute for Research and Education (IDOR) reveals impact of antibiotic resistance in 500 ICU patients during the pandemic 

Hospital-acquired infections caused by antibiotic-resistant bacteria are among the greatest challenges in modern medicine. A study led by the D’Or Institute for Research and Education (IDOR), published in Critical Care Science, analyzed data from patients in 52 Brazilian intensive care units (ICUs) between January 2019 and December 2020. It found that infections caused by antibiotic-resistant Enterobacterales doubled the risk of in-hospital death. 

COVID-19’s role in microbial resistance
The study retrospectively compared data from 250 patients infected with carbapenem-resistant Enterobacterales—broad-spectrum antibiotics used for severe infections—with another 250 patients infected with antibiotic-sensitive strains. 

The results were striking: patients with resistant infections had a significantly higher rate of sepsis (58%) compared to the control group (35%). The risk of acquiring a resistant infection was linked to higher reliance on medical equipment and ICU readmissions. Alarmingly, patients with COVID-19 and resistant infections had twice the risk of dying within 60 days of hospitalization. 

The pandemic intensified microbial resistance, partly due to the widespread and often inappropriate use of antibiotics. IDOR’s analysis highlights the need for strict antimicrobial stewardship in ICUs. 

Bacterial profiles and genetic resistance
The research also mapped the genetic profiles of resistant bacteria in Brazilian ICUs. Klebsiella pneumoniae was the most prevalent species, found in 79% of cases. Certain genes, like NDM (New Delhi metallo-beta-lactamase), were identified as key factors driving high resistance to major antibiotic classes, making treatment extremely difficult. 

The increasing presence of the NDM gene is particularly concerning, as it indicates a broader spread of this resistance mechanism, which was previously uncommon in Brazil. These bacteria’s ability to share resistance genes further complicates infection control. 

How can we fight antibiotic resistance?
These findings underscore the urgent need for measures to contain bacterial resistance, especially in critical care settings. Rational use of antimicrobials and continuous monitoring of resistance patterns are essential to prevent the spread of multidrug-resistant pathogens. 

Rapid identification of resistance genes is critical for guiding appropriate antibiotic use and improving patient outcomes. Advanced genotyping technologies allow for early detection, enabling more timely and effective interventions. 

In addition, isolating infected patients, strict hand hygiene, and robust infection control protocols are essential to curb the advance of microbial resistance. Combating antibiotic-resistant bacteria is a global challenge that requires collective action from the scientific and medical communities.