Antimicrobial resistance in and before and after the coronavirus disease 2019 (COVID-19) pandemic in the Dominican Republic.

Objective: To describe antimicrobial resistance before and after the COVID-19 pandemic in the Dominican Republic.

Design: Retrospective study.

Setting: The study included 49 outpatient laboratory sites located in 13 cities nationwide.

Participants: Patients seeking ambulatory microbiology testing for urine and bodily fluids.

Methods: We reviewed antimicrobial susceptibility reports for isolates from urine and (PSAR) from bodily fluids between January 1, 2018, to December 31, 2021, from deidentified susceptibility data extracted from final culture results.

Results: In total, 27,718 urine cultures with and 2,111 bodily fluid cultures with PSAR were included in the analysis. On average, resistance to ceftriaxone was present in 25.19% of isolated from urine each year. The carbapenem resistance rates were 0.15% for and 3.08% for PSAR annually. The average rates of with phenotypic resistance consistent with possible extended-spectrum β-lactamase (ESBL) in urine were 25.63% and 24.75%, respectively, before and after the COVID-19 pandemic. The carbapenem resistance rates in urine were 0.11% and 0.20%, respectively, a 200% increase. The average rates of PSAR with carbapenem resistance in bodily fluid were 2.33% and 3.84% before and after the COVID-19 pandemic, respectively, a 130% percent increase.

Conclusions: Resistance to carbapenems in PSAR and after the COVID-19 pandemic is rising. These resistance patterns suggest that ESBL is common in the Dominican Republic. Carbapenem resistance was uncommon but increased after the COVID-19 pandemic.