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The COVID-19 pandemic has led to significant changes in healthcare practices, including increased antibiotic usage. This study aimed to investigate the impact of the pandemic on the prevalence of extended-spectrum β-lactamase (ESBL) production and carbapenem resistance among key bacterial species causing urinary tract infections (UTIs). Conducted at King Fahad Medical City in Riyadh from January 2018 to December 2022, the study analyzed urine samples from 9697 UTI patients. Patients were categorized into 'pre-COVID-19' and 'during COVID-19' groups. Bacterial isolates were identified, and antimicrobial susceptibility testing was performed following guidelines. ESBL production was detected using the Double-Disc Synergy Test. Escherichia coli and Klebsiella pneumoniae were the main pathogens. During the pandemic, ESBL production decreased in E. coli by 1.9% and in K. pneumoniae by 6.0%. Carbapenem resistance also declined, with E. coli displaying a 1.2% reduction and K. pneumoniae and Pseudomonas aeruginosa displaying 10.7% and 7.9% reductions, respectively. Notably, logistic regression analysis revealed that the odds of ESBL presence were 10% lower during the COVID-19 pandemic (OR 0.91; 95% CI 0.83–0.99; p = 0.040), and there was a significant reduction in the odds of carbapenem resistance (OR 0.43; 95% CI 0.37–0.51; p < 0.001). This study reveals a significant decrease in ESBL production and carbapenem resistance among UTI pathogens during the COVID-19 pandemic, hinting at the impact of modified antibiotic and healthcare approaches. It emphasizes the need for persistent antimicrobial resistance surveillance and policy adaptation to address resistance challenges, offering key directions for future public health actions. [ABSTRACT FROM AUTHOR]

BACKGROUND: The novel coronavirus, officially known as COVID-19, was first reported in Wuhan, China in December of 2019. Since that time, medical services in Saudi Arabia have adapted to the situation by delivering medical care via virtual clinics. Therefore, the present study aimed to assess patients' level of satisfaction with virtual clinics during the COVID-19 pandemic in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among patients who had experienced virtual clinics in primary healthcare centers in Riyadh, Saudi Arabia. An online validated questionnaire was sent to all participants who had at least one virtual visit between March 2020 to July 2020. The data sought included demographics, level of satisfaction and questions related to their experience with virtual clinics. Computed frequencies and percentages for categorical variables, and median, mean, and standard deviation for continuous variables. Satisfaction scores were compared between groups using Mann-Whitney U test and Kruskal Wallis test. RESULTS: A total of 439 patients completed the questionnaire (response rate 97.5%); 54% were male. The participants were divided into three age groups: 18–39, 40–59, and ≥60 years. Overall level of patients' satisfaction with virtual clinic was 68.1%. Factors statistically significantly associated with satisfaction included gender, age group and level of education (post-graduate and middle school) and being well-informed on the use of telemedicine. Specific age groups that were significant were 18–39 and 40–59 years; 50.2% of the males found telemedicine very convenient, compared to only 36.1% females. Family medicine clinics were the most commonly visited virtual clinics, whereas obstetrics and gynecology clinics were the least attended virtual clinics. The inability to meet the health-care professional face-to-face was reported by 53.8% as the most important disadvantage. CONCLUSION: This study shows a high level of satisfaction with virtual clinics in Saudi Arabia during the COVID-19 pandemic despite the service being relatively new in healthcare service in the country. Our study demonstrated that satisfaction was linked to age, gender, education and the type of clinic used. [ABSTRACT FROM AUTHOR]