{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T13:04:28Z","timestamp":1771333468070,"version":"3.50.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009187","name":"Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009187","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Antimicrobial Resistance Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n The COVID-19 pandemic impacted healthcare use, with mixed reports regarding impacts on antimicrobial resistance. The aim was to identify changes in healthcare utilisation and antibiotic prescribing related to the COVID-19 pandemic and quantify subsequent impacts on antibiotic resistance in clinical Escherichia coli isolates in Scotland.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data involving \u223c490\u200a000 people from January 2018 to March 2022 were analysed. Joinpoint regression analyses identified trend changes in healthcare encounters, and antibiotic use in community and hospital settings. Using these joinpoints as an \u2018intervention\u2019 timepoint, interrupted time series analysis quantified associated changes in proportions of E. coli blood and urine culture isolates that were antibiotic resistant and multidrug resistant (MDR).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n January 2020 was identified as the intervention point. From 26% resistant (not MDR) and 35% MDR among urine E. coli isolates immediately pre-intervention, there were changes in level of +2.5% (95%CI \u22120.4% to 5.4%) and trend of +0.3% (95%CI 0.1% to 0.5%) per month for resistant (not MDR), and level change of +0.4% (95%CI \u22122.0% to 2.8%) but trend change of \u22120.3% (95%CI \u22120.5% to \u22120.1%) per month for MDR. By 9 month post-intervention, compared with predicted levels without intervention, resistant (not MDR) proportions increased while MDR proportions decreased. Similar changes occurred among blood culture isolates, but with less certainty around estimates.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Small but significant reductions in MDR E. coli resulted from COVID-19-related changes in healthcare and antibiotic use. The findings are critical for antimicrobial stewardship and infection control interventions and evaluation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jac\/dkag049","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T12:44:50Z","timestamp":1769690690000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of COVID-19-related healthcare changes on antibiotic resistance in clinical\n Escherichia coli<\/i>\n isolates: interrupted time series analyses in Scotland, UK"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9961-3151","authenticated-orcid":false,"given":"Laura","family":"Ciaccio","sequence":"first","affiliation":[{"name":"Division of Population Health and Genomics, School of Medicine, University of Dundee , Dundee ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter T","family":"Donnan","sequence":"additional","affiliation":[{"name":"Division of Population Health and Genomics, School of Medicine, University of Dundee , Dundee ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin J","family":"Parcell","sequence":"additional","affiliation":[{"name":"Division of Population Health and Genomics, School of Medicine, University of Dundee , Dundee ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charis A","family":"Marwick","sequence":"additional","affiliation":[{"name":"Division of Population Health and Genomics, School of Medicine, University of Dundee , Dundee ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"2026021707092588600_dkag049-B1","doi-asserted-by":"publisher","first-page":"7830","DOI":"10.3390\/ijerph19137830","article-title":"Practice and system factors impact on infection prevention and control in general practice during COVID-19 across 33 countries: results of the PRICOV cross-sectional survey","volume":"19","author":"Collins","year":"2022","journal-title":"Int J Environ Res Public Heal"},{"key":"2026021707092588600_dkag049-B2","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1093\/jalm\/jfaa121","article-title":"Impact of COVID-19 pandemic on laboratory utilization","volume":"5","author":"Durant","year":"2020","journal-title":"J Appl Laboratory Medicine"},{"key":"2026021707092588600_dkag049-B3","author":"World Health Organization"},{"key":"2026021707092588600_dkag049-B4","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1016\/j.cmi.2020.12.018","article-title":"Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis","volume":"27","author":"Langford","year":"2021","journal-title":"Clin Microbiol Infec"},{"key":"2026021707092588600_dkag049-B5","doi-asserted-by":"publisher","first-page":"dlab078","DOI":"10.1093\/jacamr\/dlab078","article-title":"Antibiotic prescribing for respiratory tract infection in patients with suspected and proven COVID-19: results from an antibiotic point prevalence survey in Scottish hospitals","volume":"3","author":"Seaton","year":"2021","journal-title":"JAC Antimicrobial Resist"},{"key":"2026021707092588600_dkag049-B6","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.jinf.2020.05.046","article-title":"Co-infections in people with COVID-19: a systematic review and meta-analysis","volume":"81","author":"Lansbury","year":"2020","journal-title":"Infection"},{"key":"2026021707092588600_dkag049-B7","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1016\/j.jinf.2020.09.024","article-title":"Survey of antibiotic and antifungal prescribing in patients with suspected and confirmed COVID-19 in Scottish hospitals","volume":"81","author":"Seaton","year":"2020","journal-title":"Infection"},{"key":"2026021707092588600_dkag049-B8","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/j.cmi.2024.03.018","article-title":"Epidemiology of Escherichia coli bloodstream infection antimicrobial resistance trends across South West England during the first two years of the coronavirus disease 2019 pandemic response","volume":"30","author":"Stanley","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"2026021707092588600_dkag049-B9","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.cmi.2024.07.007","article-title":"Quantifying the impact of COVID-19-related restrictions on antibiotic resistance","volume":"30","author":"Marwick","year":"2024","journal-title":"Clin Microbiol Infect"},{"key":"2026021707092588600_dkag049-B10","unstructured":"Health Informatics Centre\u2014 Datasets [Internet]. https:\/\/discovery.dundee.ac.uk\/en\/equipments\/health-informatics-centre\/datasets\/. 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