{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:29:04Z","timestamp":1785421744187,"version":"3.56.0"},"reference-count":55,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Graduate Program Scholarship from The Graduate School, Kasetsart University","award":["-"],"award-info":[{"award-number":["-"]}]},{"award":["-"],"award-info":[{"award-number":["-"]}],"id":[{"id":"https:\/\/ror.org\/05gzceg21","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004539","name":"Kasetsart University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004539","id-type":"DOI","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/05gzceg21","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: The COVID-19 pandemic disrupted healthcare systems and antimicrobial stewardship, potentially altering antimicrobial resistance patterns. This study characterized temporal changes in the proportions of multidrug-resistant organisms (MDROs) and identified associated factors before and during the pandemic at a tertiary care hospital in northeastern Thailand. Methods: A single-center retrospective observational study was conducted at Roi Et Hospital, including 5458 culture-confirmed MDRO cases (2017\u20132022), stratified into pre-pandemic (2017\u20132019) and pandemic (2020\u20132022) periods. Pathogen-specific resistance proportions were compared using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression identified independently associated factors within each period. Results: The proportion of MDRO cases classified as hospital-acquired increased from 40.71% to 57.41% (p &lt; 0.001). Carbapenem-resistant Acinetobacter baumannii (CRAB) increased markedly (22.87% to 76.11%; OR 10.75, 95% CI 9.43\u201312.26), followed by carbapenem-resistant Enterobacterales (CRE) (4.05% to 21.61%; OR 6.54, 95% CI 5.84\u20137.32) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) (14.32% to 27.15%; OR 2.23, 95% CI 1.87\u20132.65; all p &lt; 0.001). Vancomycin-resistant Enterococcus (VRE) declined significantly (OR 0.41, 95% CI 0.25\u20130.68; p &lt; 0.001). Methicillin-resistant Staphylococcus aureus (MRSA) showed a higher proportion among clinical isolates (3.28% to 6.34%; OR 2.01, 95% CI 1.42\u20132.83), although without a consistent annual trend. In multivariable analyses, ICU admission was independently associated with lower odds of CRE (aOR 0.52) and CRPA (aOR 0.63) and with higher odds of CRAB (aOR 2.13; all p &lt; 0.001). Conclusions: The COVID-19 pandemic was associated with a major proportional shift toward carbapenem-resistant Gram-negative pathogens, with distinct profiles of associated factors across CRAB, CRE, and CRPA. These findings highlight the need for pathogen-specific infection prevention and antimicrobial stewardship strategies during healthcare system disruptions.<\/jats:p>","DOI":"10.3390\/medsci14030366","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:50:33Z","timestamp":1782924633000},"page":"366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in the Epidemiology of Multidrug-Resistant Organisms During the COVID-19 Pandemic: A Six-Year Retrospective Study at a Tertiary Care Hospital in Northeastern Thailand"],"prefix":"10.3390","volume":"14","author":[{"given":"Tassawan","family":"Pangseeta","sequence":"first","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuksanai","family":"Pussadu","sequence":"additional","affiliation":[{"name":"Service Quality and Standards Development Division, Roi Et Hospital, Roi-Et 45000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuntiput","family":"Putthanachote","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, Roi-Et Hospital, Roi-Et 45000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-602X","authenticated-orcid":false,"given":"Jaruwan","family":"Tawarungruang","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1584-0578","authenticated-orcid":false,"given":"Birabongse","family":"Hardthakwong","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-2937","authenticated-orcid":false,"given":"Parichart","family":"Boueroy","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1739-0805","authenticated-orcid":false,"given":"Ratchadaporn","family":"Ungcharoen","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1555-401X","authenticated-orcid":false,"given":"Piroon","family":"Jenjaroenpun","sequence":"additional","affiliation":[{"name":"Medical Bioinformatics, Siriraj Genomics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"},{"name":"Siriraj Long-Read Lab (Si-LoL), Medical Bioinformatics Lab, Siriraj Genomics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1055-3656","authenticated-orcid":false,"given":"Anusak","family":"Kerdsin","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5010-4682","authenticated-orcid":false,"given":"Peechanika","family":"Chopjitt","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Chalermphrakiat Sakon Nakhon Province Campus, Kasetsart University, Sakon Nakhon 47000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","article-title":"Global burden of bacterial antimicrobial resistance 1990\u20132021: A systematic analysis with forecasts to 2050","volume":"404","author":"Naghavi","year":"2024","journal-title":"Lancet"},{"key":"ref_2","unstructured":"World Health Organization (2022). 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