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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]

Misophonia, a neurobehavioral syndrome, reduces tolerance to specific stimuli and impacts various domains of life. It is also strongly correlated with obsessive-compulsive disorder (OCD) and depression. This study aimed to investigate the prevalence of misophonia among medical students at King Saud University (KSU), Saudi Arabia, identify related sociodemographic factors, and assess misophonia association with OCD and depression. This cross-sectional study included 371 participants. The study tool was distributed electronically between November 19 and December 07, 2023. It consisted of 4 sections: a questionnaire developed by the research team, the Amsterdam Misophonia Scale (A-MISO-S), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Patient Health Questionnaire-9 (PHQ-9). The results indicated that 42.32% of the participants had previously experienced misophonia, with symptoms developing suddenly in 28.66%. The majority of participants had subclinical misophonia (71.16%) and minimal depression (37.47%), with a significant proportion experiencing mild-to-severe misophonia (28.84%) and varying degrees of depression (33.15%). Approximately 31.00% of the students exhibited likely OCD. The PHQ-9 and A-MISO-S scores showed weak positive correlations, whereas the OCI-R and A-MISO-S scores showed a moderate positive correlation. Furthermore, a moderate positive correlation was observed between the OCI-R and PHQ-9 scores. Multiple logistic regression analysis revealed that sex, family history of misophonia, depression severity, and OCD were significantly associated with clinical misophonia. This study underscores the significance of recognizing misophonia among medical students and its associated factors, such as OCD and depression. Further multicenter studies using more rigorous research methodologies are warranted., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)