Antibiotic Resistance in Staphylococcus aureus at a Jamaican Hospital: A comparison of the Pre-pandemic and Pandemic Periods

Abstract

To compare antibiotic resistance patterns in patterns of methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) isolates collected before and during the COVID-19 pandemic at a tertiary care hospital in Jamaica.
Methods
A retrospective analysis of antibiotic susceptibility data was conducted by extracting demographic and antibiogram information from the laboratory information system at the University Hospital of the West Indies. The analysis included comparisons between deduplicated cases of S. aureus isolated during the pre-pandemic period (March 10, 2016, to May 5, 2019) and the pandemic period (March 10, 2020, to May 5, 2023). Significant differences in the demographic proportions of cases and their resistance rates to first-line and second-line antibiotics were identified using the independent t-test, chi-square test and Fisher’s exact test (p < 0.05).
Results
Of 2649 de-duplicated cases of S. aureus infections that were identified across the pre-pandemic (n=1541) and pandemic period (n=1108), the MRSA rates remained at 6.2%. There was no significant difference in susceptibility to other first-line agents (clindamycin, erythromycin and gentamicin) and second line agents (rifampin, minocycline, trimethoprim-sulfamethoxazole and linezolid) between the pre-pandemic and pandemic periods. Although only 8 isolates were tested against linezolid, of significance there was no reported resistance to this drug.
Conclusion
The COVID-19 pandemic didn't significantly change the antibiotic resistance of S. aureus (including MRSA) in this setting, unlike in other areas. These findings, when compared to other healthcare settings, highlight the variable impact of the pandemic on MRSA rates, influenced by differences in healthcare responses and infection control measures. Nonetheless, the projected regional predilection to progressively increasing disease outbreaks by the Caribbean Public Health Agency (CARPHA) is a specific risk for increasing AMR, and in addition to universal risks, underscores the importance of surveillance studies like these which could help to inform AMR mitigation measures.