{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:20:26Z","timestamp":1793193626022,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Overuse of antibiotics during coronavirus disease 2019 (COVID-19) in an attempt to reduce COVID-19 mortality in the short term may have contributed to long-term mortality from antimicrobial resistance (AMR). The aim\u00a0of this study\u00a0was to evaluate the impact of the COVID-19 pandemic on AMR in Egypt and map the\u00a0distribution of multidrug-resistant (MDR) and extensive drug-resistant (XDR) across Egypt. Through a multicenter cross-sectional study 2430 culture results were collected in 2019 and 2022 pre and post-COVID-19 pandemic\u00a0in Egypt,\u00a0including 400\n                    <jats:italic>Klebsiella pneumoniae,<\/jats:italic>\n                    760\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , 650\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    , and\u00a0620\n                    <jats:italic>Methicillin-resistant<\/jats:italic>\n                    <jats:italic>staphylococcus<\/jats:italic>\n                    <jats:italic>aureus<\/jats:italic>\n                    \u00a0(MRSA) culture results. MDR and XDR culture results distribution across Egypt was highlighted through the geographic information system. Mixed effect logistic regression models and sub-group analysis were performed according to the type of specimens\u00a0to test the impact of COVID-19 on resistance. Adjusted analysis demonstrated\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    resistance has increased against quinolones and carbapenems (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Resistance of\n                    <jats:italic>E. coli<\/jats:italic>\n                    has increased significantly against imipenem and meropenem. While\n                    <jats:italic>E.coli<\/jats:italic>\n                    susceptibility has increased to cefoxitin, levofloxacin, and ciprofloxacin.\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    resistance has increased more than double against ceftazidime, cefepime, and piperacillin-tazobactam (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). MRSA reserved its susceptibility to vancomycin and linezolid. MDR\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    and\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    have increased post-COVID-19 from 67%\u00a0to 94% and from 79% to\u00a098%, respectively (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). XDR\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    and\n                    <jats:italic>A. baumannii<\/jats:italic>\n                    have increased\u00a0from 6% to\u00a046%, and\u00a0from 47% to 69%, respectively (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). COVID-19 has\u00a0changed the profile of AMR in Egypt so that\u00a0urgent action is required to mitigate this threat and preserve our capacity to face infections in future decades.\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-56254-4","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T11:04:27Z","timestamp":1711451067000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Antimicrobial resistance burden pre and post-COVID-19 pandemic with mapping the multidrug resistance in Egypt: a comparative cross-sectional study"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-6396","authenticated-orcid":false,"given":"Shaimaa","family":"Abdelaziz Abdelmoneim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-706X","authenticated-orcid":false,"given":"Ramy","family":"Mohamed Ghazy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9801-0607","authenticated-orcid":false,"given":"Eman","family":"Anwar Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud A.","family":"Hassaan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1950-2428","authenticated-orcid":false,"given":"Mohamed","family":"Anwar Mahgoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"issue":"10325","key":"56254_CR1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"CJ Murray","year":"2022","unstructured":"Murray, C. J. et al. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 399(10325), 629\u2013655 (2022).","journal-title":"Lancet"},{"issue":"9","key":"56254_CR2","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1093\/cid\/ciaa773","volume":"72","author":"R Nieuwlaat","year":"2021","unstructured":"Nieuwlaat, R. et al. Coronavirus disease 2019 and antimicrobial resistance: parallel and interacting health emergencies. Clin. Infect. Dis. 72(9), 1657\u20131659 (2021).","journal-title":"Clin. Infect. Dis."},{"issue":"1","key":"56254_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1093\/jacamr\/dlac130","volume":"5","author":"LS Witt","year":"2023","unstructured":"Witt, L. S. et al. The impact of COVID-19 on multidrug-resistant organisms causing healthcare-associated infections: a narrative review. JAC Antimicrobial Res. 5(1), 130 (2023).","journal-title":"JAC Antimicrobial Res."},{"issue":"1","key":"56254_CR4","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.jhin.2020.05.020","volume":"106","author":"D Don\u00e0","year":"2020","unstructured":"Don\u00e0, D., Di Chiara, C. & Sharland, M. Multi-drug-resistant infections in the COVID-19 era: a framework for considering the potential impact. J. Hosp. Infect. 106(1), 198\u2013199 (2020).","journal-title":"J. Hosp. Infect."},{"issue":"3","key":"56254_CR5","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1002\/jmv.26441","volume":"93","author":"A Goncalves Mendes Neto","year":"2021","unstructured":"Goncalves Mendes Neto, A. et al. Bacterial infections and patterns of antibiotic use in patients with COVID-19. J. Med. Virol. 93(3), 1489\u20131495 (2021).","journal-title":"J. Med. Virol."},{"key":"56254_CR6","doi-asserted-by":"publisher","first-page":"150873","DOI":"10.1016\/j.scitotenv.2021.150873","volume":"807","author":"SG Rizvi","year":"2022","unstructured":"Rizvi, S. G. & Ahammad, S. Z. COVID-19 and antimicrobial resistance: A cross-study. Sci. Total Environ. 807, 150873 (2022).","journal-title":"Sci. Total Environ."},{"issue":"1","key":"56254_CR7","doi-asserted-by":"publisher","first-page":"4516","DOI":"10.21608\/ejhm.2022.258482","volume":"89","author":"SHN Taha","year":"2022","unstructured":"Taha, S. H. N. et al. Assessment of self-treatment knowledge, beliefs and practice during COVID-19 pandemic among Egyptian population: A cross sectional study. Egypt. J. Hosp. Med. 89(1), 4516\u20134525 (2022).","journal-title":"Egypt. J. Hosp. Med."},{"issue":"1","key":"56254_CR8","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s13756-022-01085-z","volume":"11","author":"RM Kariyawasam","year":"2022","unstructured":"Kariyawasam, R. M. et al. Antimicrobial resistance (AMR) in COVID-19 patients: A systematic review and meta-analysis (November 2019\u2013June 2021). Antimicrobial Res. Infect. Control 11(1), 45 (2022).","journal-title":"Antimicrobial Res. Infect. Control"},{"issue":"1","key":"56254_CR9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13756-021-01048-w","volume":"11","author":"R Khoshbakht","year":"2022","unstructured":"Khoshbakht, R. et al. Assessment of antibiotic resistance changes during the Covid-19 pandemic in northeast of Iran during 2020\u20132022: An epidemiological study. Antimicrobial Res. Infect. Control 11(1), 1\u201311 (2022).","journal-title":"Antimicrobial Res. Infect. Control"},{"issue":"8","key":"56254_CR10","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.3390\/antibiotics12081297","volume":"12","author":"N Ablakimova","year":"2023","unstructured":"Ablakimova, N. et al. Microbial landscape and antibiotic-susceptibility profiles of microorganisms in patients with bacterial pneumonia: A comparative cross-sectional study of COVID-19 and Non-COVID-19 cases in Aktobe, Kazakhstan. Antibiotics 12(8), 1297 (2023).","journal-title":"Antibiotics"},{"key":"56254_CR11","doi-asserted-by":"publisher","first-page":"E179","DOI":"10.1016\/S2666-5247(22)00355-X","volume":"4","author":"BJ Langford","year":"2023","unstructured":"Langford, B. J. et al. Antimicrobial resistance in patients with COVID-19: a systematic review and meta-analysis. Lancet Microbe 4, E179\u2013E191 (2023).","journal-title":"Lancet Microbe"},{"issue":"3","key":"56254_CR12","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1093\/jac\/dkg101","volume":"51","author":"A El Kholy","year":"2003","unstructured":"El Kholy, A. et al. Antimicrobial resistance in Cairo, Egypt 1999\u20132000: A survey of five hospitals. J. Antimicrob. Chemother. 51(3), 625\u2013630 (2003).","journal-title":"J. Antimicrob. Chemother."},{"issue":"9","key":"56254_CR13","doi-asserted-by":"publisher","first-page":"e61","DOI":"10.1016\/j.ajic.2011.04.009","volume":"39","author":"T Saied","year":"2011","unstructured":"Saied, T. et al. Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt. Am. J. Infect. Control 39(9), e61\u2013e65 (2011).","journal-title":"Am. J. Infect. Control"},{"key":"56254_CR14","unstructured":"Macrotrends. Egypt Population 1950\u20132024. 2024 [cited 2024 Feburary 22]; https:\/\/www.macrotrends.net\/countries\/EGY\/egypt\/population."},{"key":"56254_CR15","unstructured":"James S. Lewis II, M.e.P.s.f.a.s.t., 33rd edition, Clinical and Laboratory Standards Institute. Accessed 16 Sept 2023 https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/ (). ."},{"key":"56254_CR16","doi-asserted-by":"publisher","first-page":"1905","DOI":"10.2147\/IDR.S298920","volume":"14","author":"A El-Kholy","year":"2021","unstructured":"El-Kholy, A. et al. Landscape of multidrug-resistant gram-negative infections in Egypt: survey and literature review. Infect. Drug Res. 14, 1905\u20131920 (2021).","journal-title":"Infect. Drug Res."},{"issue":"05","key":"56254_CR17","doi-asserted-by":"publisher","first-page":"795","DOI":"10.3855\/jidc.15833","volume":"16","author":"A-AE Alfeky","year":"2022","unstructured":"Alfeky, A.-A.E. et al. High prevalence of multi-drug resistant methicillin-resistant Staphylococcus aureus in tertiary Egyptian Hospitals. J. Infect. Dev. Ctries 16(05), 795\u2013806 (2022).","journal-title":"J. Infect. Dev. Ctries"},{"issue":"3","key":"56254_CR18","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"A-P Magiorakos","year":"2012","unstructured":"Magiorakos, A.-P. et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin. Microbiol. Infect. 18(3), 268\u2013281 (2012).","journal-title":"Clin. Microbiol. Infect."},{"key":"56254_CR19","doi-asserted-by":"crossref","unstructured":"Tamma, P.D., A.S., Bonomo, R.A., Mathers, A.J., van Duin, D., Clancy, C.J. Infectious diseases society of america antimicrobial-resistant treatment guidance: Gram-negative bacterial infections. (Infectious Diseases Society of America 2023; Version 3.0, accessed 27Sept 2023 Available at https:\/\/www.idsociety.org\/practice-guideline\/amr-guidance\/..","DOI":"10.1093\/cid\/ciad428"},{"issue":"19","key":"56254_CR20","doi-asserted-by":"publisher","first-page":"11931","DOI":"10.3390\/ijerph191911931","volume":"19","author":"HJA Sulayyim","year":"2022","unstructured":"Sulayyim, H. J. A. et al. Antibiotic resistance during COVID-19: A systematic review. Int. J. Environ. Res. Public Health 19(19), 11931 (2022).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"5","key":"56254_CR21","doi-asserted-by":"publisher","first-page":"957","DOI":"10.3390\/microorganisms10050957","volume":"10","author":"F Serapide","year":"2022","unstructured":"Serapide, F. et al. Is the pendulum of antimicrobial drug resistance swinging back after COVID-19?. Microorganisms 10(5), 957 (2022).","journal-title":"Microorganisms"},{"issue":"3","key":"56254_CR22","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.3390\/ijerph20031681","volume":"20","author":"R Magnano San Lio","year":"2023","unstructured":"Magnano San Lio, R., Favara, G., Maugeri, A., Barchitta, M. & Agodi A. How antimicrobial resistance is linked to climate change: an overview of two intertwined global challenges. Int. J. Environ. Res. Public Health 20(3), 1681 (2023).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"6","key":"56254_CR23","doi-asserted-by":"publisher","first-page":"e03733","DOI":"10.1128\/spectrum.03733-22","volume":"10","author":"F Nicola","year":"2022","unstructured":"Nicola, F. et al. Outbreak of Klebsiella pneumoniae ST11 resistant to ceftazidime-avibactam producing KPC-31 and the novel variant KPC-115 during COVID-19 pandemic in Argentina. Microbiol. Spectr. 10(6), e03733-22 (2022).","journal-title":"Microbiol. Spectr."},{"issue":"1","key":"56254_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-023-08397-4","volume":"23","author":"AK Helmy","year":"2023","unstructured":"Helmy, A. K. et al. Emergence of microbial infections in some hospitals of Cairo, Egypt: Studying their corresponding antimicrobial resistance profiles. BMC Infect. Dis. 23(1), 1\u201313 (2023).","journal-title":"BMC Infect. Dis."},{"issue":"46","key":"56254_CR25","doi-asserted-by":"publisher","first-page":"2200845","DOI":"10.2807\/1560-7917.ES.2022.27.46.2200845","volume":"27","author":"P Kinross","year":"2022","unstructured":"Kinross, P. et al. Large increase in bloodstream infections with carbapenem-resistant Acinetobacter species during the first 2 years of the COVID-19 pandemic, EU\/EEA, 2020 and 2021. Eurosurveillance 27(46), 2200845 (2022).","journal-title":"Eurosurveillance"},{"key":"56254_CR26","first-page":"250","volume":"8","author":"RF Syed","year":"2022","unstructured":"Syed, R. F., Yelamanchili, S. & Thati, S. A comparative study of Acinetobacter infections in COVID and non-COVID patients. J. Infect. Dis. Epidemiol 8, 250 (2022).","journal-title":"J. Infect. Dis. Epidemiol"},{"issue":"2","key":"56254_CR27","first-page":"156","volume":"13","author":"EH Wardoyo","year":"2021","unstructured":"Wardoyo, E. H. et al. Antibiotics susceptibility of Escherichia coli isolates from clinical specimens before and during COVID-19 pandemic. J. Microbiol. 13(2), 156 (2021).","journal-title":"J. Microbiol."},{"issue":"1","key":"56254_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-023-08202-2","volume":"23","author":"A Azzam","year":"2023","unstructured":"Azzam, A. et al. Epidemiology of clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and its susceptibility to linezolid and vancomycin in Egypt: A systematic review with meta-analysis. BMC Infect. Dis. 23(1), 1\u201315 (2023).","journal-title":"BMC Infect. Dis."},{"key":"56254_CR29","doi-asserted-by":"crossref","unstructured":"Pa\u0142ka, A., et al. Secondary bacterial infections & extensively drug-resistant bacteria among COVID-19 hospitalized patients at the University Hospital in Krak\u00f3w. (2023).","DOI":"10.21203\/rs.3.rs-2428958\/v1"},{"issue":"4","key":"56254_CR30","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.3390\/jcm12041298","volume":"12","author":"P-H Wicky","year":"2023","unstructured":"Wicky, P.-H. et al. Ventilator-associated pneumonia in COVID-19 patients admitted in intensive care units: relapse, therapeutic failure and attributable mortality\u2014A multicentric observational study from the outcomerea network. J. Clin. Med. 12(4), 1298 (2023).","journal-title":"J. Clin. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56254-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56254-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56254-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T11:05:48Z","timestamp":1711451148000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56254-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,26]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["56254"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-56254-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,26]]},"assertion":[{"value":"25 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7176"}}