{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:33:39Z","timestamp":1790706819136,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Asociaci\u00f3n Nacional de Investigaci\u00f3n y Desarrollo"},{"DOI":"10.13039\/501100002850","name":"Fondo Nacional de Desarrollo Cient\u00edfico y Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002850","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002850","name":"CIFAR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002850","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The impact of coronavirus disease 2019 (COVID-19) on antimicrobial use (AU) and resistance has not been well evaluated in South America. These data are critical to inform national policies and clinical care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>At a tertiary hospital in Santiago, Chile, between 2018 and 2022, subdivided into pre- (3\/2018\u20132\/2020) and post\u2013COVID-19 onset (3\/2020\u20132\/2022), we evaluated intravenous AU and frequency of carbapenem-resistant Enterobacterales (CRE). We grouped monthly AU (defined daily doses [DDD]\/1000 patient-days) into broad-spectrum \u03b2-lactams, carbapenems, and colistin and used interrupted time-series analysis to compare AU during pre- and post-pandemic onset. We studied the frequency of carbapenemase-producing (CP) CRE and performed whole-genome sequencing analyses of all carbapenem-resistant (CR) Klebsiella pneumoniae (CRKpn) isolates collected during the study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with pre-pandemic, AU (DDD\/1000 patient-days) significantly increased after the pandemic onset, from 78.1 to 142.5 (P &amp;lt; .001), 50.9 to 110.1 (P &amp;lt; .001), and 4.1 to 13.3 (P &amp;lt; .001) for broad-spectrum \u03b2-lactams, carbapenems, and colistin, respectively. The frequency of CP-CRE increased from 12.8% pre\u2013COVID-19 to 51.9% after pandemic onset (P &amp;lt; .001). The most frequent CRE species in both periods was CRKpn (79.5% and 76.5%, respectively). The expansion of CP-CRE harboring blaNDM was particularly noticeable, increasing from 40% (n = 4\/10) before to 73.6% (n = 39\/53) after pandemic onset (P &amp;lt; .001). Our phylogenomic analyses revealed the emergence of two distinct genomic lineages of CP-CRKpn: ST45, harboring blaNDM, and ST1161, which carried blaKPC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>AU and the frequency of CP-CRE increased after COVID-19 onset. The increase in CP-CRKpn was driven by the emergence of novel genomic lineages. Our observations highlight the need to strengthen infection prevention and control and antimicrobial stewardship efforts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad151","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T19:39:38Z","timestamp":1688585978000},"page":"S20-S28","source":"Crossref","is-referenced-by-count":39,"title":["Antibiotic Consumption During the Coronavirus Disease 2019 Pandemic and Emergence of Carbapenemase-Producing <i>Klebsiella pneumoniae<\/i> Lineages Among Inpatients in a Chilean Hospital: A Time-Series Study and Phylogenomic Analysis"],"prefix":"10.1093","volume":"77","author":[{"given":"Kasim","family":"Allel","sequence":"first","affiliation":[{"name":"Department of Disease Control, London School of Hygiene and Tropical Medicine , London , United Kingdom"},{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Institute for Global Health, University College London , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Peters","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Conejeros","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 R W","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Spencer-Sandino","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Riquelme-Neira","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"},{"name":"N\u00facleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agron\u00f3micas, Facultad de Medicina Veterinaria y Agronom\u00eda, Universidad de las Am\u00e9ricas , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Rivas","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Rojas","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Orellana Chea","sequence":"additional","affiliation":[{"name":"Hospital Padre Hurtado , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Departamento de Laboratorios Cl\u00ednicos, Escuela de Medicina, Universidad Cat\u00f3lica de Chile , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Araos","sequence":"additional","affiliation":[{"name":"Multidisciplinary Initiative for Collaborative Research On Bacterial Resistance (MICROB-R) , Santiago , Chile"},{"name":"Genomics and Resistant Microbes (GeRM), Facultad de Medicina Cl\u00ednica Alemana, Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Universidad del Desarrollo , Santiago , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"McGovern","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twisha S","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar A","family":"Arias","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Houston Methodist Hospital , Texas , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda C","family":"Lessa","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia , 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