PETERS, ANNE SOPHIE

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PETERS, ANNE SOPHIE
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ORCID
0000-0003-4641-5837
Scopus Author ID
57220744660

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    P-186. Trends in Antimicrobial Resistance Among Adults Across 6 Hospitals in Argentina, Brazil, and Chile, 2018-2022
    (Oxford University Press (OUP), 2025-01-29)
    Siza, Charlene R
    ;
    Mahon, Garrett W
    ;
    Patel, Twisha S
    ;
    Garzon, Maria I
    ;
    Boszczowski, Icaro
    Background In 2019, an estimated 1.27 million deaths were attributed to bacterial antimicrobial resistance (AR) globally. During the Coronavirus Disease 2019 (COVID-19) Pandemic, additional strain was placed on healthcare systems that may have led to further increases in AR. We evaluated AR prevalence before and after the onset of COVID-19 in 6 healthcare facilities (HCF) in South America. Methods We conducted an ecological evaluation of HCF-wide AR prevalence in 4 private and 2 public HCFs in Argentina, Brazil, and Chile; 2 HCFs per country. We calculated percentage of non-susceptible (NS) or resistant (R) to select antibiotics among clinical isolates of Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus spp., and Enterobacterales cultured from adult acute care inpatients. We compared percentage-NS or -R between the periods pre- (March 2018–February 2020) and post- (March 2020–February 2022) onset of the COVID-19 pandemic. Chi-square or Fisher’s exact tests were used with statistical significance set at a two-tailed p< 0.05. Results When comparing 2020-2022 to 2018-2020, 2/6 hospitals showed statistically significant increases (+14.1–19.2%) in carbapenem-NS A. baumannii. For carbapenem-NS P. aeruginosa, 1/6 hospitals showed a significant increase (+76.6%) and 1/6 showed a significant decrease (-52.4%). For carbapenem-NS Enterobacterales, 2/6 hospitals had significant increases (+50.7–236.2%) and 1 exhibited a significant decrease (-91.7%). For vancomycin-R Enterococcus spp., 2/6 hospitals had significant increases (+43.9–400.0%) and 2/6 hospitals had significant decreases (-49.0-60.7%). For Enterobacterales-R to 3rd generation cephalosporins, 2/6 hospitals showed significant increases (+16.0–110.9%) and 1/6 hospitals had a significant decrease (-40.4%) (Table). Conclusion Among the isolates from our study hospitals, we noted not only significant increases but also significant decreases across multiple AR profiles associated with multi-drug resistance. These data suggest that the pandemic may have led to changes in resistance among both gram-negative and gram-positive bacteria. Given the variability in these changes, further evaluation of infection rates would be valuable to confirm these findings. Disclosures José M Munita, MD, MSD: Grant/Research Support|Pfizer: Grant/Research Support
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    P-175. Assessing the Dynamics of Fecal Colonization with Antibiotic-Resistant Bacteria in a Chilean Cohort: A Longitudinal Study
    (Oxford University Press (OUP), 2025-01-29)
    Rafael, Araos
    ;
    Jara, Alejandro
    ;
    Sanchez, Felipe
    ;
    Adell, Aiko
    ;
    Olivares, Jorge
    Background In low- and middle-income countries, the community burden of antibiotic-resistant Gram-negative bacteria (AR-GNB) colonization is high. Understanding factors influencing AR-GNB colonization is crucial for controlling antimicrobial resistance. Methods We conducted a cohort study from December 2019 to November 2020 with community-dwelling adults in Molina, an agricultural town in Central Chile. We collected questionnaires and fecal samples every two weeks for six months to identify colonization by extended-spectrum cephalosporin-resistant Enterobacterales (ESCRE). ESCRE detection involved selective media screening, MALDI-TOF identification, and disk-diffusion antibiotic-susceptibility testing. We assessed the impact of epidemiological and clinical features and exposure to various water sources, foods, and animals on i) baseline ESCRE fecal colonization, ii) ESCRE acquisition during follow-up, and iii) ESCRE clearance. The study included 198 subjects, using multiple imputations for missing predictor values. We used two hidden Markov models for each dataset, with Model 1 assuming perfect sensitivity and specificity and Model 2 estimating sensitivity. A Bayesian approach with Markov chain Monte Carlo algorithms estimated odds ratios (OR) and credible intervals (CI). Results The sample consisted of 198 residents with a mean age of 60.9 and a predominance of women (75%). Model 1 showed that treating drinking water before consumption reduced the risk of baseline ESCRE colonization (OR: 0.38; 95% CI: 0.02 – 0.89). No significant associations were found for ESCRE acquisition during follow-up. Males and individuals with comorbidities had a lower risk of clearing ESCRE (ORs: 0.58, 0.54; CIs: 0.24 – 0.97, 0.258 – 0.88, respectively). Model 2, with imperfect sensitivity, showed similar results. Conclusion This study highlights the significance of environmental and individual health factors in ESCRE colonization. Interventions like treating drinking water could reduce baseline ESCRE colonization risk. The varied impacts of gender and comorbidities on ESCRE clearance provide insights for targeted AR-GNB management strategies. Further research is needed to understand these associations and develop effective community-level interventions against AMR. Disclosures All Authors: No reported disclosures
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    Antimicrobial use and documented infection among hospitalized adults in South American acute care facilities during the coronavirus disease 2019 (COVID-19) pandemic
    (Public Library of Science (PLoS), 2026-02-27)
    Lauren F. Dempsey
    ;
    Hanako Osuka
    ;
    Olivia L. McGovern
    ;
    MUNITA SEPULVEDA, JOSE MANUEL  
    ;
    Maria Isabel Garzon
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>Despite low bacterial and fungal infection rates, increased antimicrobial use (AU) among hospitalized patients has been reported during the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated whether COVID-19 was a driver of AU and documented bacterial or fungal infection.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods</jats:title> <jats:p>We conducted a retrospective cohort study in two hospitals each in Argentina, Brazil, and Chile. We included hospitalized adults with and without COVID-19 admitted during the pandemic (March 2020-February 2021) as well as a cohort admitted prior to the pandemic (March 2019-February 2020) with similar age and length of hospitalization. We performed multivariable logistic regressions to compare 1) patients with COVID-19 to those without who were admitted during the pandemic, and 2) patients without COVID-19 who were admitted during the pandemic to a similar patient population before the pandemic to characterize the association of COVID-19 or admission during the pandemic with rates of AU and infections.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>A total of 1116 patients were included. During the pandemic, COVID-19 was not associated with receiving antimicrobials or receiving antimicrobials for a duration &gt;48 hours, but it was associated with reduced likelihood of culture-positive bacterial or fungal infection (aOR=0.35, 95% CI: 0.19–0.64, p &lt; 0.001). Compared to patients without COVID-19 admitted during the pandemic, patients admitted prior to the pandemic were more likely to have received antimicrobials (aOR=1.54, 95% CI: 1.15–2.07, p &lt; 0.01), but there was no association with receiving antimicrobials for duration&gt;48 hours or having a culture-positive bacterial or fungal infection.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusions</jats:title> <jats:p>COVID-19 was not associated with an increased likelihood of AU in this cohort of hospitalized adults.</jats:p> </jats:sec>
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