A Review on Pre- and Post-COVID-19 Evaluation of Antimicrobial Susceptibility for Healthcare-associated Infections

Abstract

Healthcare-associated infections (HAIs) pose a significant threat to patient safety, with antimicrobial resistance (AMR) exacerbating the challenge. The COVID-19 pandemic introduced profound shifts in infection control practices, antimicrobial usage, and diagnostic strategies, impacting antimicrobial susceptibility patterns in HAIs. This review examines the pre- and post-COVID-19 trends in antimicrobial susceptibility for common HAIs, exploring the influences of pandemic-era healthcare protocols. Pre-pandemic data highlighted rising resistance levels due to antibiotic misuse, particularly in intensive care units (ICUs). The pandemic accelerated the overuse of broad-spectrum antibiotics, driven by misdiagnosed bacterial superinfections and limited diagnostic resources. Consequently, post-pandemic surveillance data indicate an alarming increase in resistant pathogens, including Klebsiellapneumoniae, Acinetobacterbaumannii, and Candidaauris. This review also addresses the role of strengthened infection control policies during COVID-19, such as enhanced hygiene measures and antimicrobial stewardship programs, which varied in their effectiveness across settings. Furthermore, it highlights the need for comprehensive, real-time AMR monitoring systems and global collaboration to mitigate future resistance challenges. By integrating lessons learned from the pandemic, this review emphasizes the importance of balancing antimicrobial stewardship with effective infection control strategies to safeguard public health against evolving resistance trends in HAIs.