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

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...

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Main Authors: Daisuke Miyamori, Shuhei Yoshida, Kotaro Ikeda, Masanori Ito
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125000565
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author Daisuke Miyamori
Shuhei Yoshida
Kotaro Ikeda
Masanori Ito
author_facet Daisuke Miyamori
Shuhei Yoshida
Kotaro Ikeda
Masanori Ito
author_sort Daisuke Miyamori
collection DOAJ
description 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.
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spelling doaj-art-35cb4499ecde416ebcf7daa5be1bd62b2025-08-20T02:15:51ZengElsevierJournal of Infection and Public Health1876-03412025-05-0118510270710.1016/j.jiph.2025.102707Evaluating 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 databaseDaisuke Miyamori0Shuhei Yoshida1Kotaro Ikeda2Masanori Ito3Correspondence to: Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.; Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, JapanDepartment of General Internal Medicine, Hiroshima University Hospital, Hiroshima, JapanDepartment of General Internal Medicine, Hiroshima University Hospital, Hiroshima, JapanDepartment of General Internal Medicine, Hiroshima University Hospital, Hiroshima, JapanBackground: 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.http://www.sciencedirect.com/science/article/pii/S1876034125000565J-SIPHEAMRStreptococcus pneumoniaeHaemophilus influenzaeDecreased incidence rateInterrupted time series analysis
spellingShingle Daisuke Miyamori
Shuhei Yoshida
Kotaro Ikeda
Masanori Ito
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
Journal of Infection and Public Health
J-SIPHE
AMR
Streptococcus pneumoniae
Haemophilus influenzae
Decreased incidence rate
Interrupted time series analysis
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic J-SIPHE
AMR
Streptococcus pneumoniae
Haemophilus influenzae
Decreased incidence rate
Interrupted time series analysis
url http://www.sciencedirect.com/science/article/pii/S1876034125000565
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