{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:40:18Z","timestamp":1788381618362,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>The World Health Organization released a statement warning of increased risk for the incidence of multidrug resistant microorganisms and the absence of new drugs to control such infections soon. Since the beginning of the COVID-19 pandemic, the prescription of antimicrobial agents has increased and may have accelerated the emergence of multidrug resistant (MDR) bacteria. This study aimed to evaluate maternal and pediatric infections within a hospital from January 2019 to December 2021. An observational retrospective cohort study was performed at a quaternary referral hospital in a metropolitan area of Niteroi city, Rio de Janeiro state, Brazil. A total of 196 patients\u2019 medical records were analyzed. The data from 90 (45.9%) patients were collected before the SARS-CoV-2 pandemic, 29 (14.8%) from the 2020 pandemic period, and 77 (39.3%) from the 2021 pandemic period. A total of 256 microorganisms were identified during this period. Out of those, 101 (39.5%) were isolated in 2019, 51 (19.9%) in 2020, and 104 (40.6%) in 2021. Antimicrobial susceptibility tests were performed on 196 (76.6%) clinical isolates. The exact binomial test showed that the distribution of Gram-negative bacteria was predominant. The most common microorganism was <jats:italic>Escherichia coli<\/jats:italic> (23%; <jats:italic>n<\/jats:italic>\u2009=\u200945), followed by <jats:italic>Staphylococcus aureus<\/jats:italic> (17.9%, <jats:italic>n<\/jats:italic>\u2009=\u200935), <jats:italic>Klebsiella pneumoniae<\/jats:italic> (12.8%, <jats:italic>n<\/jats:italic>\u2009=\u200925), <jats:italic>Enterococcus faecalis<\/jats:italic> (7.7%, <jats:italic>n<\/jats:italic>\u2009=\u200915), <jats:italic>Staphylococcus epidermidis<\/jats:italic> (6.6%, <jats:italic>n<\/jats:italic>\u2009=\u200913) and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (5.6%, <jats:italic>n<\/jats:italic>\u2009=\u200911). <jats:italic>Staphylococcus aureus<\/jats:italic> was the predominant species among resistant bacteria. Among the antimicrobial agents tested, the following were resistant, presented on a descending scale: penicillin (72.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001, Binomial test), oxacillin (68.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.006, Binomial test), ampicillin (64.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003, Binomial test), and ampicillin\/sulbactam (54.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.57, Binomial test). Infections with <jats:italic>S. aureus<\/jats:italic> were 3.1 times greater in pediatrics and maternal units than in other hospital wards. Despite the global reduction in the incidence of MRSA, we observed an increase in MDR <jats:italic>S. aureus<\/jats:italic> in this study. No changes were observed in the frequency of resistance profiles of the clinical isolates after the establishment of the global SARS-CoV-2 pandemic. More comprehensive studies are needed to understand the impact of the global SARS-CoV-2 pandemic on the resistance levels of bacteria associated with neonate and pediatric patients.<\/jats:p>","DOI":"10.3389\/fmicb.2023.1096223","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T04:53:22Z","timestamp":1676868802000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of changes in antimicrobial susceptibility in bacteria infecting children and their mothers in pediatric, neonatal-intensive care unit, and gynecology\/obstetrics wards of a quaternary referral hospital during the COVID-19 pandemic"],"prefix":"10.3389","volume":"14","author":[{"given":"Felipe Ramos","family":"Pinheiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaela Elvira","family":"Rozza-de-Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Camille","family":"Blum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Freire Alves","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaqueline Abel","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina F.","family":"Guedes Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno A.","family":"Penna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee W.","family":"Riley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Aguiar-Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1093\/cid\/ciab688","article-title":"The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections","volume":"74","author":"Baker","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1016\/S2214-109X(20)30109-1","article-title":"Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study","volume":"8","author":"Bonet","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1590\/SciELOPreprints.362","volume-title":"Monitoring the Number of COVID-19 Cases and Deaths in Brazil at Municipal and Federative Unit Levels","author":"Cota","year":"2020"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1007\/s10096-018-3292-9","article-title":"Incidence and antimicrobial resistance trends in bloodstream infections caused by ESKAPE and Escherichia coli at a large teaching hospital in Rome, a 9-year analysis (2007-2015)","volume":"37","author":"De Angelis","year":"2018","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e13687","DOI":"10.1111\/eci.13687","article-title":"Protective effect of SARS-CoV-2 preventive measures against ESKAPE and Escherichia coli infections","volume":"51","author":"Gaspari","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1056\/NEJMoa1914433","article-title":"Multidrug-resistant bacterial infections in U.S. hospitalized patients, 2012\u20132017","volume":"382","author":"Jernigan","year":"2020","journal-title":"N. Engl. J. 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Chemother."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1086\/533452","article-title":"Federal Funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE","volume":"197","author":"Rice","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.mib.2011.11.006","article-title":"Pathogens and the placental fortress","volume":"15","author":"Robbins","year":"2012","journal-title":"Curr. Opin. Microbiol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"101613","DOI":"10.1016\/j.tmaid.2020.101613","article-title":"COVID-19 in Latin America: the implications of the first confirmed case in Brazil","volume":"35","author":"Rodriguez-Morales","year":"2020","journal-title":"Travel Med. Infect. 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