{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T07:41:29Z","timestamp":1792914089884,"version":"4.5.0"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"abstract":"<jats:p>\n                    Antimicrobial resistance (AMR) was exacerbated by COVID-19 pandemic. This study describes prevalence and trends of AMR in patients with diagnosed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted during 2020\u20132022 to the intensive care unit (ICU) in Molise region, central Italy. A retrospective study was conducted, including patients aged \u2265 18 years with at least one positive bacterial or fungal culture during ICU stay. Data were related to patient demographics, ICU outcomes, healthcare-associated infections, and antimicrobial susceptibility profiles. During the 2020\u20132022 period, 103 ICU admissions met the inclusion criteria, yielding 268 isolations, of which 157 underwent antimicrobial susceptibility testing. Apart from high proportion of\n                    <jats:italic toggle=\"yes\">Candida albicans<\/jats:italic>\n                    , Gram-negative bacteria predominated, with\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                    among the most frequent. Resistance to beta-lactams and carbapenems was consistently high, while it ranged from 53.8% to 66.7% to fluoroquinolones and remained above 50% to aminoglycosides. Tetracycline resistance showed significant year-to-year variation, increasing in 2022 compared with both 2020 and 2021. AMR rates in COVID-19 patients in ICU were persistently high throughout the pandemic, with critical resistance levels in Gram-negatives, underlining the need to reinforce infection prevention and control measures and antimicrobial stewardship programs and align prescribing practices with World Health Organization AWaRe recommendations, even during public health emergencies.\n                  <\/jats:p>","DOI":"10.1177\/10766294261500546","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T10:19:12Z","timestamp":1792577952000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial Resistance Trends in COVID-19 Patients with Hospital Infection in Intensive Care: A Retrospective Study in Central Italy, 2020\u20132022"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9953-7769","authenticated-orcid":false,"given":"Giancarlo","family":"Ripabelli","sequence":"first","affiliation":[{"name":"Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Salzo","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"De Dona","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Viccione","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicandro","family":"Samprati","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Santagata","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Adesso","sequence":"additional","affiliation":[{"name":"Pescara Health Authority, Pescara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela Anna","family":"Di Palma","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Natale","sequence":"additional","affiliation":[{"name":"Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romeo","family":"Flocco","sequence":"additional","affiliation":[{"name":"Former Director Intensive Care Unit of \u201cA. Cardarelli\u201d hospital, Molise Regional Health Agency, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela Lucia","family":"Sammarco","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Tamburro","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"1.World Health Organization (WHO). Antimicrobial resistance. World Health Organization: Geneva Switzerland; 2020. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance [Last accessed: 20August 2025]."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30605-4"},{"key":"e_1_3_2_4_1","unstructured":"3.World Health Organization (Awho) Regional Office for Europe\/European Centre for Disease Prevention and Control (ECDC). Antimicrobial resistance surveillance in Europe 2022\u20132020 data. Copenhagen: WHO Regional Office for Europe; 2022. Available from: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/antimicrobial-resistance-surveillance-europe-2022-2020-data [Last accessed: 10September 2025]."},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5394"},{"issue":"10","key":"e_1_3_2_6_1","first-page":"1240","article-title":"Management of infections caused by difficult-to-treat gram-negative bacteria in the ICU during the COVID-19 Pandemic: Narrative review","volume":"10","author":"Bassetti M","year":"2021","unstructured":"5.Bassetti M, , Giacobbe DR, , Vena A, et al. Management of infections caused by difficult-to-treat gram-negative bacteria in the ICU during the COVID-19 Pandemic: Narrative review. Antibiotics 2021;10(10):1240.","journal-title":"Antibiotics"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.07.016"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa530"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-022-01113-y"},{"key":"e_1_3_2_10_1","unstructured":"9.Istituto Superiore di Sanit\u00e0. AR-ISS: Sorveglianza nazionale dell\u2019Antibiotico-Resistenza. Istituto Superiore di Sanit\u00e0 (ISS): Rome Italy; 2023. Available from: https:\/\/www.epicentro.iss.it\/antibiotico-resistenza\/ar-iss\/RIS-4_2023.pdf [Last accessed: 11September 2025]."},{"issue":"4","key":"e_1_3_2_11_1","first-page":"E463","article-title":"Healthcare infections and antimicrobial consumption in pre-COVID-19 era: A point prevalence survey in three hospitals in a region of Central Italy","volume":"64","author":"Tamburro M","year":"2024","unstructured":"10.Tamburro M, , Salzo A, , Sammarco ML, , Ripabelli G. Healthcare infections and antimicrobial consumption in pre-COVID-19 era: A point prevalence survey in three hospitals in a region of Central Italy. J Prev Med Hyg 2024;64(4):E463\u2013E470.","journal-title":"J Prev Med Hyg"},{"issue":"3","key":"e_1_3_2_12_1","first-page":"181","article-title":"Public health, personalized medicine, and COVID-19 in the pre-vaccination phase: A narrative review of the literature on unfavorable prognostic factors in Italian patients","volume":"46","author":"Tamburro M","year":"2022","unstructured":"11.Tamburro M, , Ripabelli G, , Salzo A, , Sammarco ML. Public health, personalized medicine, and COVID-19 in the pre-vaccination phase: A narrative review of the literature on unfavorable prognostic factors in Italian patients. Epidemiol Prev 2022;46(3):181\u2013191.","journal-title":"Epidemiol Prev"},{"key":"e_1_3_2_13_1","unstructured":"12.European Centre for Disease Prevention and Control (ECDC). Antimicrobial resistance in the EU\/EEA (EARS-Net). Annual Epidemiological Report for 2022. ECDC: Stockholm Sweden; 2023. Available from: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/AER-antimicrobial-resistance.pdf [Last accessed: 12September 2025]."},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlaf037"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14080796"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/trab048"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13225"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jof6040286"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.12.018"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261500546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10766294261500546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10766294261500546","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T07:17:36Z","timestamp":1792912656000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10766294261500546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":18,"alternative-id":["10.1177\/10766294261500546"],"URL":"https:\/\/doi.org\/10.1177\/10766294261500546","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"article-number":"10766294261500546"}}