Trend analysis of carbapenem-resistant Gram-negative bacteria and antimicrobial consumption in the post-COVID-19 era, an extra challenge for healthcare institutions.

We analyzed the incidence density trend of the carbapenem-resistant Gram-negative bacteria in device-associated infections and antimicrobial consumption in 99 critical care facilities in a low middle-income country, between January 2019 and December 2020. Carbapenem-resistant A. baumannii (CRAB)/1,000 patient-day increased in 2020 and this finding had a strong positive correlation with the incidence density of COVID-19 by the Spearman´s test. Polymyxin consumption also increased in 2020 but without significant correlation to CRAB or COVID-19 incidence density, presumably due to empirical and untargeted prescribing as a consequence of concern about CRAB infections. These findings are a warning to infection control programmes and antimicrobial stewardship.