Antimicrobial Resistance Patterns in Hazara Division: A Cross-Sectional Study in The Pre-and Post-Covid-19 Era

In COVID-19 there was a lot of misuse of antibiotics that caused the huge burden of antimicrobial resistance (AMR). The study focuses on the impact of COVID-19 on AMR. A total of 1200 samples of urine, PUS, wound, blood, and high vaginal swab (HVS) were collected out of which 529 samples were included while 200 were excluded. Selected samples were cultured and antibiotic disks were applied. Zone size determined antibiotic sensitivity, resistance levels. The statistical analysis was done by using R version 4.3.0. The most commonly isolated bacteria were Escherichia coli (46%) followed by the Staphylococcus spp (18.4%), Klebsiella spp (9.7%), Enterococcus spp (5.5%), Coliform spp (4.9%), Pseudomonas spp (3.6%), Enterobacter spp (3.2%), Candida spp (2.3%), Acinetobacter spp (2.1%), Salmonella typhi (1.1%), Streptococcus spp (1.1%), Proteus mirabilis (0.9%), Burkholderia cepacia (0.4%), Citrobacter freundii (0.5%), Morgenella spp (0.2%). In Females (76%) AMR while in males 23.6% AMR was observed. A total of 42 antibiotics AMR trend was seen out of which 21 antibiotics show an uptrend while others show a downtrend. During COVID-19 the increased use of antibiotics occurred so the increased AMR is seen in 2019 and 2020. Post-COVID-19 identification, reduced antibiotic usage resulted in an observed downward trend.