Possible scenarios of the development of antibiotic resistance in patients with urinary tract infection after the COVID-19 pandemic era | Krakhotkin | Uro-Technology Journal

Open Access | Editorial
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Possible scenarios of the development of antibiotic resistance in patients with urinary tract infection after the COVID-19 pandemic era

Denis V. Krakhotkinoa, Volodymyr A. Chernylovskyib, *, Francesco Grecoc, Shuhrat M. Halilovd

a Central District Hospital, Outpatient Department, Kamenolomni, Rostov Region 346480, Russia.
b Private Urological Practice, Dnipro, Ukraine.
c Urology Unit, Centro Salute Uomo, Bergamo, Italy.
d Department of Urology, City Clinical Hospital No 1, Tashkent, Uzbekistan.

* Corresponding author: Volodymyr A. Chernylovskyi
Mailing address: Private Urological Practice, Dnipro, Ukraine.
Email: chernylovskyi@gmail.com

Received: 04 October 2022 / Published: 29 December 2022

DOI: 10.31491/UTJ.2022.12.003


An outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative pathogen for COVID-19 was reported at the end of December 2019 in Wuhan, Hubei province, China, and by March 2020, it was declared a pandemic COVID-19. In hospital and critical care department settings, the majority of patients with COVID-19 receive broad-spectrum antibiotics for treatment of secondary infection complications. In patients affected by COVID-19, who had a suspected secondary bacterial superinfection, antibiotics including teicoplanin, clarithromycin, doxycycline, azithromycin, tetracyclines, levofloxacin, moxifloxacin, ciprofloxacin, and cephalosporins 3d generation were proposed as an effective treatment. In this editorial, we will consider possible scenarios of the development of antibiotic resistance after the pandemic COVID-19 in patients with urinary tract infection (UTI).


COVID-19, antibiotic resistance, urinary tract infection, bacterial superinfection


The World Health Organization (WHO) acknowledged that the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative pathogen for COVID-19, has the potential risk to spread worldwide and by 11 March 2020, the WHO designated the disease caused by this virus, coronavirus disease 2019 (COVID-19), to be a pandemic. [1, 2]. Pathogenesis of SARS-CoV-2 is related to the recognition of the receptor on the host cell membrane, through the CoV spike (S) glycoprotein on its surface. Subsequently, this leads to various clinical manifestations, including fever, dry cough, abatement and loss of olfactory and taste senses, pneumonia, respiratory failure, lymphopenia, and thrombotic complications [3- 5]. In hospital and intensive care units (ICU) settings, the majority of patients with COVID-19 routinely receive antibiotics for treatment of secondary bacterial infection complications, including teicoplanin, clarithromycin, doxycycline, tetracyclines, levofloxacin, azithromycin, moxifloxacin, ciprofloxacin, and cephalosporins 3d generation. In one meta-analysis, Langford et al. demonstrated that fluoroquinolones and third-generation cephalosporins comprised about 74% of all antibiotics prescribed to patients affected by COVID-19 [6, 7]. In one study, Bardi et al. reported that the prevalence of urinary tract infection (UTI) in patients with COVID-19 hospitalized in the ICU was only 8% and E. faecium and E. faecalis were predominant bacterial pathogens. Meanwhile, in another study, Marand et al. demonstrated that about 41% of patients with COVID-19 had a positive bacterial urine culture without clinical symptoms of UTI, where E. coli, Klebsiella pneumonia, and Proteus were the most common uropathogenic [8, 9]. Nowadays, there are several reports about COVID-19-associated cystitis, which can be related to an increased release of urinary inflammatory cytokines or the direct interaction of SARS-CoV 2 with the mucosa of the urinary bladder [10- 12]. In this Editorial, we will consider possible scenarios of the development of antibiotic resistance after the pandemic COVID-19 in patients with UTI.

The current level of resistance to different antibiotics for UTIs caused by common uropathogens

Traditionally, microorganisms of the Enterobacteriaceae family represent the most relevant etiological factors for different UTIs [13]. Nowadays, there are many of data about the level of resistance to different antibiotics. Despite on definitive success of antibiotic therapy for the treatment of UTI, antimicrobial resistance remains a main public health problem in the world [14, 15]. Among different multidrug-resistant microorganisms (MDM), E. coli is the most common causative pathogen associated with UTI, followed by Klebsiella spp, Enterococcus spp, and other gram-negative bacteria. Antibiotic resistance develops through the following mechanisms: efflux, exclusion, target modification, sequestration, and covalent inactivation [16]. The choice of treatment for UTIs is usually based on history, laboratory findings, results of a urinalysis and urine culture, and clinical presentation. Unfortunately, the majority of patients who developed a UTI, have generally recurrent upper and lower urinary tract infections. Nevertheless, current EAU and AUA guidelines cannot always provide detailed microbiological and clinical therapy for these clinical cases. To face this problem, urologists and general practitioners have tried to elaborate therapeutical schemes based on urine culture results and rates of antibiotic resistance. The increase or decrease in resistance rates to each specific antibiotic depends on the frequency of its use as empirical therapy. Table 1 summarized the results of different studies about rates of resistance for a widely used antibiotic for UTI caused by the most prevalent uropathogens.

Table 1
The rates of resistance for widely used antibiotics for UTI caused by the most common uropathogenic.

Reference Pathogen Rates of resistance (%)
Meena M et al. [13] Escherichia coli 72.5 - 78.75 - - - - -
Klebsiella pneumonia 23.75 - 23.75 - - - - -
Stapleton et al. [17] Escherichia coli 11.44-25.5 - - - - 32.6-48 - -
Wong et al. [18] Escherichia coli 23.4 - 31.8 0.9 - - - -
Rossignol et al. [19] Escherichia coli - - - - 97.1 - - -
Yang et al. [20] Escherichia coli 16.4-25.3 18.1-25.7 24.1-30.2 2.8-7.5 - - - -
Pseudomonas aeruginosa 59.4-63.3 56.3-61.2 71.4-78.1 3.1-4.1 - - - -
Klebsiella pneumonia 14.3-26.1 14.3-26.1 31.9-40.9 7.7-11.4 - - - -
Proteus mirabilis 13.8-19.5 12.1-14.6 22.4-46.3 0-7.3 - - - -
Rizwan et al. [21] Escherichia coli 62.16 51.35 75 - - 33.33 10.41 -
Klebsiella pneumonia 30 25 67 3.1-4.1 - 25 63.63 -
Zilberberg et al. [22] Escherichia coli 43.5 43.5 36.9 0 15.1 - 6.7 5.1
Klebsiella pneumonia 15.3 15.3 20.4 0.1 13.2 - 60.8 13.2
Proteus mirabilis 55.6 55.6 40.7 0.1 7.9 - 73.7 7.9
Pseudomonas aeruginosa 34.4 34.4 4.2 0 12 - 8.8 12
Bahramian et al. [23] Escherichia coli 75 34.4 79.2 6.6 71.6 - 10.8 -
Romero Palacios et al. [24] Escherichia coli 24.2 - 18.6 - 7.8 - 5.5 -
Klebsiella pneumonia 6.4 - 8.2 - 6.4 - 63.6 -
Proteus mirabilis 10 - 14 - 6 - 96 -
Bitew et al. [25] Escherichia coli 50.4 55.6 70.4 - 34.8 45.2 20 -
Klebsiella pneumonia 16.7 11.1 66.7 - 44.4 22.2 61.1 -
Pseudomonas aeruginosa 33.3 0 100 - 100 100 100 -
Al Wutayd et al. [26] Escherichia coli 56.1 - 49 - - 72 14.6 -
Klebsiella pneumonia 34.3 - 47.1 - - 77.1 82.9 -
Proteus mirabilis 58.8 - 58.8 - - 64.7 94.1 -
Pseudomonas aeruginosa 66.7 - 100 - - 95.8 95.8 -
Jalil et al. [27] Escherichia coli 35.4 82.9 53.7 - 89 - - -
Klebsiella pneumonia - 78.9 71.1 - - - - -

Potential adverse effects of COVID-19 on anti biotic therapy for UTI

Despite on implemented numerous infection control measures and prevention strategies, such as mask-wearing,adequate hand hygiene, social distancing, rapid testing on COVID-19, and avoiding the large crowd of people, the rates of antimicrobial resistance are still increasing and the increased emergence of multi-drug resistant microorganisms is representing a huge health public problem during ongoing pandemic COVID-19 [28, 29]. Above 70% of patients with COVID-19 received antibiotic therapy; however, the rates of microbiologically confirmed bacterial co-infection did not exceed 20-30% [30, 31]. It is worth noting that 57-64.3% of all bacterial coinfections in patients affected by SARS-CoV-2 are localized in the genitourinary tract [32, 33]. During the pandemic COVID-19, both in non-ICU and ICU settings, clinicians used for the treatment of secondary bacterial co-infection following antibiotics: teicoplanin, clarithromycin, doxycycline, azithromycin, tetracyclines, levofloxacin, moxifloxacin, ciprofloxacin, and cephalosporins 3d generation. In a monocenter, retrospective study, third-generation cephalosporins, and amoxiclav represented the most used antibiotics in patients with COVID-19 admitted to ICU [34]. The study conducted in Cipto Mangunkusumo Hospital showed that antibiotics were prescribed to 82.4% of the patients with SARS-CoV-2, and macrolides, cephalosporins, and quinolones were administered in 33%, 25%, and 17% of the cases, respectively. Furthermore, azithromycin, ceftriaxone, cefotaxime, cefoperazone, levofloxacin, and moxifloxacin represented the most used therapy [35]. In one study, Khurana et al. reported the highest resistance of amoxiclav (84%), followed by levofloxacin (83%), ciprofloxacin (79%), and trimethoprim/sulfamethoxazole (75%). However, resistance in urine samples was highest for amoxiclav (100%) and nitrofurantoin (50%). The lower rates of resistance were reported for ciprofloxacin, levofloxacin, and trimethoprim/sulfamethoxazole in 16.7%, 25%, and 33.3% of the cases, respectively [36]. In COVID-19 clinic settings during the hospitalization period, there was a high rate of antibiotic prescribing and many patients received more than one antibiotic [37, 38]. The prevalence of hospital-acquired UTI in hospitalized COVID-19 patients was 89.6%. Catheter-associated UTIs were the most common type (55.5%) and bacterial coinfections were predominantly determined by E. coli and Enterococcus faecalis [39]. Despite low rates of bacterial coinfection, antibiotic overtreatment is still high and currently, there are no unified antibiotic stewardship programs during the ongoing pandemic COVID-19 [40, 41].

Possible scenarios development of antibiotic resistance in patients with UTI after the pandemic COVID-19

As of 23 August 2022, there have been 594,367,247 confirmed cases of COVID-19 and 6,451,016 deaths globally. At the same time, 12,409,086,286 vaccine doses have been worldwide administered [42]. Nine mRNA vaccines based on the Wuhan-Hu-1 strain showed high efficacy against symptomatic cases of COVID-19. However, despite the successful COVID-19 vaccination strategies, there is still a global threat of emerging antimicrobial resistance due to the overconsumption of antibiotics in patients affected by COVID-19 [43- 45]. Therefore, all healthcare and scientific societies should share guidelines in antibiotic therapy, which have to include as following: the monitoring of antibiotic prescribing practices and external benchmarking; staff education on appropriate antibiotic administration; antibiotic restriction with approval systems for broad-spectrum drugs and adequate feedback to the antibiotic prescriber. Considering, the abovementioned trends of antibiotic resistance in patients with UTI alone or in association with SARS-CoV-2 infection, we hypothesized the following possible scenarios for the development of antimicrobial resistance (AMR): 1) Baseless administration of fluoroquinolones, thirdgeneration cephalosporins, amoxiclav, and other antibiotics in patients with UTIs alone or association with SARSCoV-2 infection may significantly increase current rates of antimicrobial resistance. 2) The successful COVID-19 vaccination significantly reduces hospitalization rates; however, injudicious use of antibiotics in patients with UTI may also increase the rates of antimicrobial resistance. 3) Significant reduction of resistance to the most commonly used antibiotics in the treatment of UTIs by the development of reliable guidelines for antibiotic treatment and by increasing the number of COVID-19 vaccinations (thus decreasing the hospitalization rates). 4) Low rates of COVID-19 vaccinations and overconsumption of antibiotics in the community may significantly increase antimicrobial resistance in patients with UTIs alone or association with SARS-CoV-2 infection.


The development of unified reliable guidelines for antibiotic therapy including the treatment of UTIs as a single clinical event or in association with SARS-CoV-2 infection and an increased rate of COVID-19 vaccinated patients could represent the best way to decrease the rates of antimicrobial resistance of the commonly used antibiotic for treating UTI.


Authors’ contributions

Contributed to the study conception and design: Krakhotkin D.V and Chernylovskyi V.A. Critical revision of the manuscript and editing: Francesco Greco and Shuhrat M. Halilov.

Availability of data and materials

Not applicable.

Financial support and sponsorship


Conflicts of interest

Krakhotkin D.V, Chernylovskyi V.A,and Francesco Greco are members of the Editorial Board of Uro-Technology Journal. All authors declare they have no conflict of interest.

Ethical approval and consent to participate

Not applicable.

Consent for publication

Not applicable.


1. Sharma A, Ahmad Farouk I, & Lal SK. COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention. Viruses, 2021, 13(2). [Crossref]

2. Koelle K, Martin MA, Antia R, Lopman B, & Dean NE. The changing epidemiology of SARS-CoV-2. Science, 2022, 375(6585): 1116-1121. [Crossref]

3. Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science, 2020, 367(6483): 1260-1263. [Crossref]

4. Mohamadian M, Chiti H, Shoghli A, Biglari S, Parsamanesh N, & Esmaeilzadeh A. COVID-19: Virology, biology and novel laboratory diagnosis. J Gene Med, 2021, 23(2): e3303. [Crossref]

5. Shen WX, Luo RC, Wang JQ, & Chen ZS. Features of Cytokine Storm Identified by Distinguishing Clinical Manifestations in COVID-19. Front Public Health, 2021, 9: 671788. [Crossref]

6. Beović B, Doušak M, Ferreira-Coimbra J, Nadrah K, Rubulotta F, Belliato M, et al. Antibiotic use in patients with COVID-19: a ‘snapshot’ Infectious Diseases International Research Initiative (ID-IRI) survey. J Antimicrob Chemother, 2020, 75(11): 3386-3390. [Crossref]

7. Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect, 2020, 26(12): 1622-1629. [Crossref]

8. Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, Azzam Lopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis, 2021, 40(3): 495-502. [Crossref]

9. Marand AJB, Bach C, Janssen D, Heesakkers J, Ghojazadeh M, Vögeli TA, et al. Lower urinary tract signs and symptoms in patients with COVID-19. BMC Infect Dis, 2021, 21(1): 706. [Crossref]

10. Lamb LE, Dhar N, Timar R, Wills M, Dhar S, & Chancellor MB. COVID-19 inflammation results in urine cytokine elevation and causes COVID-19 associated cystitis (CAC). Med Hypotheses, 2020, 145: 110375. [Crossref]

11. Mumm JN, Osterman A, Ruzicka M, Stihl C, Vilsmaier T, Munker D, et al. Urinary Frequency as a Possibly Overlooked Symptom in COVID-19 Patients: Does SARSCoV-2 Cause Viral Cystitis? Eur Urol, 2020, 78(4): 624- 628. [Crossref]

12. Lamb LE, Timar R, Wills M, Dhar S, Lucas SM, Komnenov D, et al. Long COVID and COVID-19-associated cystitis (CAC). Int Urol Nephrol, 2022, 54(1): 17-21. [Crossref]

13. Meena M, Kishoria N, Meena DS, & Sonwal VS. Bacteriological Profile and Antibiotic Resistance in Patients with Urinary Tract Infection in Tertiary Care Teaching Hospital in Western Rajasthan India. Infect Disord Drug Targets, 2021, 21(2): 257-261. [Crossref]

14. Gul A, & Gurbuz E. Microorganisms and antibiotic susceptibilities isolated from urine cultures. Arch Ital Urol Androl, 2020, 92(2). [Crossref]

15. Amawi HA, U’Wais H T, Nusair MB, Al-Okour R, Amawi S, Al-Shatnawi S, et al. Management of urinary tract infections and antibiotic susceptibility patterns of bacterial isolates. Int J Clin Pract, 2021, 75(10): e14475. [Crossref]

16. Munita JM, & Arias CA. Mechanisms of Antibiotic Resistance. Microbiol Spectr, 2016, 4(2). [Crossref]

17. Stapleton PJ, Lundon DJ, McWade R, Scanlon N, Hannan MM, O’Kelly F, et al. Antibiotic resistance patterns of Escherichia coli urinary isolates and comparison with antibiotic consumption data over 10 years, 2005-2014. Ir J Med Sci, 2017, 186(3): 733-741. [Crossref]

18. Wong CKM, Kung K, Au-Doung PLW, Ip M, Lee N, Fung A, et al. Antibiotic resistance rates and physician antibiotic prescription patterns of uncomplicated urinary tract infections in southern Chinese primary care. PLoS One, 2017, 12(5): e0177266. [Crossref]

19. Rossignol L, Vaux S, Maugat S, Blake A, Barlier R, Heym B, et al. Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study. Infection, 2017, 45(1): 33-40. [Crossref]

20. Yang B, Yang F, Wang S, Wang Q, Liu Z, Feng W, et al. Analysis of the spectrum and antibiotic resistance of uropathogens in outpatients at a tertiary hospital. J Chemother, 2018, 30(3): 145-149. [Crossref]

21. Rizwan M, Akhtar M, Najmi AK, & Singh K. Escherichia coli and Klebsiella pneumoniae Sensitivity/Resistance Pattern Towards Antimicrobial Agents in Primary and Simple Urinary Tract Infection Patients Visiting University Hospital of Jamia Hamdard New Delhi. Drug Res (Stuttg), 2018, 68(7): 415-420. [Crossref]

22. Zilberberg MD, Nathanson BH, Sulham K, & Shorr AF. Antimicrobial Susceptibility and Cross-Resistance Patterns among Common Complicated Urinary Tract Infections in U.S. Hospitals, 2013 to 2018. Antimicrob Agents Chemother, 2020, 64(8) [Crossref]

23. Bahramian A, Eslami G, Hashemi A, Tabibi A, & Heidary M. Emergence of fosfomycin resistance among isolates of Escherichia coli harboring extended-spectrum and AmpC β-lactamases. Acta Microbiol Immunol Hung, 2018, 65(1): 15-25. [Crossref]

24. Romero Palacios A, Al Dhufairi F, Ellis C, Smyth D, Mieusement LMD, McGeer A, et al. Resistance patterns of Enterobacteriaceae in urines are similar in symptomatic and asymptomatic patients. J Hosp Infect, 2018, 99(4): 419-421. [Crossref]

25. Bitew A, Molalign T, & Chanie M. Species distribution and antibiotic susceptibility profile of bacterial uropathogens among patients complaining urinary tract infections. BMC Infect Dis, 2017, 17(1): 654. [Crossref]

26. Al Wutayd O, Al Nafeesah A, Adam I, & Babikir I. The antibiotic susceptibility patterns of uropathogens isolated in Qassim, Saudi Arabia. J Infect Dev Ctries, 2018, 12(11): 946-952. [Crossref]

27. Jalil MB, & Al Atbee MYN. The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections. J Clin Lab Anal, 2022, 36(9): e24619. [Crossref]

28. Li Z, Chen Q, Feng L, Rodewald L, Xia Y, Yu H, et al. Active case finding with case management: the key to tackling the COVID-19 pandemic. Lancet, 2020, 396(10243): 63- 70. [Crossref]

29. Lucien MAB, Canarie MF, Kilgore PE, Jean-Denis G, Féné- lon N, Pierre M et al. Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resourcelimited settings. Int J Infect Dis, 2021, 104: 250-254. [Crossref]

30. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 2020, 395(10229): 1054-1062. [Crossref]

31. Adler H, Ball R, Fisher M, Mortimer K, & Vardhan MS. Low rate of bacterial co-infection in patients with COVID-19. Lancet Microbe, 2020, 1(2): e62. [Crossref]

32. Goncalves Mendes Neto A, Lo KB, Wattoo A, Salacup G, Pelayo J, DeJoy R, 3rd, et al. Bacterial infections and patterns of antibiotic use in patients with COVID-19. J Med Virol, 2021, 93(3): 1489-1495. [Crossref]

33. Milas S, Poncelet A, Buttafuoco F, Pardo A, Lali SE, & Cherifi S. Antibiotic use in patients with Coronavirus disease 2019 (COVID-19): outcomes and associated factors. Acta Clin Belg, 2022, 77(3): 579-587. [Crossref]

34. Contou D, Claudinon A, Pajot O, Micaëlo M, Longuet Flandre P, Dubert M, et al. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU. Ann Intensive Care, 2020, 10(1): 119. [Crossref]

35. Lie KC, Shakinah S, Pasaribu A, Sinto R, & Nainggolan L. Observational Study on Secondary Bacterial Infection and the Use of Antibiotics in COVID-19 Patients Treated in a Tertiary Referral Hospital. Acta Med Indones, 2022, 54(2): 161-169.

36. Khurana S, Singh P, Sharad N, Kiro VV, Rastogi N, Lathwal A, et al. Profile of co-infections & secondary infections in COVID-19 patients at a dedicated COVID-19 facility of a tertiary care Indian hospital: Implication on antimicrobial resistance. Indian J Med Microbiol, 2021, 39(2): 147- 153. [Crossref]

37. Stevens RW, Jensen K, O’Horo JC, & Shah A. Antimicrobial prescribing practices at a tertiary-care center in patients diagnosed with COVID-19 across the continuum of care. Infect Control Hosp Epidemiol, 2021, 42(1): 89-92. [Crossref]

38. Martin AJ, Shulder S, Dobrzynski D, Quartuccio K, & Pillinger KE. Antibiotic Use and Associated Risk Factors for Antibiotic Prescribing in COVID-19 Hospitalized Patients. J Pharm Pract, 2021: 8971900211030248. [Crossref]

39. Díaz Pollán B, Guedez López GV, García Clemente PM, Jiménez González M, García Bujalance S, & Gómez-Gil Mirá MR. Urinary Tract Infections in Hospitalized COVID-19 Patients, What’s Up, Doc? J Clin Med, 2022, 11(7). [Crossref]

40. Kyriazopoulou E, & Giamarellos-Bourboulis EJ. Antimicrobial Stewardship Using Biomarkers: Accumulating Evidence for the Critically Ill. Antibiotics (Basel), 2022, 11(3). [Crossref]

41. Zuglian G, Ripamonti D, Tebaldi A, Cuntrò M, Riva I, Farina C, et al. The changing pattern of bacterial and fungal respiratory isolates in patients with and without COVID-19 admitted to intensive care unit. BMC Infect Dis, 2022, 22(1): 185. [Crossref]

42. WHO. WHO coronavirus (COVID-19) dashboard. Covid19.who.int, 2022. [Accessed 23 August 2022]. Available from: https://covid19.who.int/

43. Hadj Hassine I. Covid-19 vaccines and variants of concern: A review. Rev Med Virol, 2022, 32(4): e2313. [Crossref]

44. Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, & PeifferSmadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect, 2022, 28(2): 202-221. [Crossref]

45. Ghosh S, Bornman C, & Zafer MM. Antimicrobial Resistance Threats in the emerging COVID-19 pandemic: Where do we stand? J Infect Public Health, 2021, 14(5): 555-560. [Crossref]

Subscribe to receive issue release notifications
and newsletters from journals