COVID-19 “Perfect Storm” for Efforts to Reduce Antibacterial Resistance

In the United States, both antimicrobial-resistant infections and associated deaths increased by approximately 15%, following previous improving trends in both areas. This 2020 trend is attributed to the “perfect storm” of the COVID-19 pandemic wave. 2022 Special Report From the Centers for Disease Control and Prevention (CDC).

Report, COVID-19 Impact on US antimicrobial resistanceWas developed primarily by the CDC’s Antibiotic Resistance Modulation and Strategic Unit. It is located within the Healthcare Quality Promotion Department of the Centers for Disease Control and Prevention.

Confluences of pandemic elements that have reversed progression to antibiotic-resistant infections include a surge in antibiotic use for increasing numbers of patients with serious, unexplained illnesses, often with catheters or man-made. It contained medical equipment at risk of infection, such as the respiratory tract.

In addition, the report identified healthcare workers, equipment, and resources that were inadequate to address the growing number of critically ill patients while implementing infection prevention and management guidance and maintaining antimicrobial management programs. The latter contributed not only to the proliferation of “super bug” infections, but also to the data gaps that the CDC would have included in its reports.

CDC Directors Rochelle Walensky, MD, and MPH said before the report, “These setbacks can be temporary and must be temporary. The COVID-19 pandemic. Revealed that prevention is a preparation. “

“After responding to COVID-19 for more than two years, the threat of antimicrobial resistance is not only still present, but even more pronounced,” she emphasized.

The magnitude of the threat is documented in the report, with more than 29,400 deaths from health-related antibiotic-resistant infections during the first year of the pandemic, 40% of which occurred during hospitalization.

Data on nine pathogens, which the CDC regularly monitors the development of resistance to available therapies, have been delayed or unavailable since 2020. From the available data, treatment-resistant infections that occur during hospitalization increased by 13% to 78% in 2020.

• Carbapenem resistance Acinetobacter, Hospitalization increased by 78%. 35% overall
• Antifungal resistance White ears 60% increase overall
• Carbapenem-resistant Enterobacter, hospitalization increased by 35%.Overall stable
• Antifungal resistance Candida, Hospitalization increased by 26%. 12% overall
• Enterobacterales, which produce extended spectrum beta-lactamase (ESBL), hospitalization increased by 32%. 10% overall
• Vancomycin-resistant enterococci, hospitalization increased by 14%. 16% overall
• Multidrug resistance Pseudomonas aeruginosa, Hospitalization increased by 32%.Overall stable
• Methicillin resistance Staphylococcus aureus, Hospitalization increased by 13%.Overall stable

The report highlights the disruption of antibiotic prescribing patterns and notes that as the number of cases of COVID-19 in hospitals increased, so did the amount of antibiotics. Antibiotics were frequently started on admission, but several studies later showed that patients admitted with COVID-19 rarely contracted a bacterial infection.

About half of the inpatients received ceftriaxone. The report states that it was generally prescribed with azithromycin. This prescribing pattern suggests that it reflects the difficulty of distinguishing COVID-19 from community-acquired pneumonia on admission.

As the number of cases of COVID-19 increased, the use of antibiotics also surged in nursing homes. In particular, azithromycin usage increased by 150% in April 2020 and by 82% in December 2020 from the same month of 2019. Antibiotic use in outpatient settings decreased in 2020. This is due to the overall decrease in medical care for outpatients. Like the epidemic of other respiratory illnesses that often leads to the prescription of antibiotics.

Wallensky sought the ability to increase investment and reduce antimicrobial-resistant infections while preparing for new public health threats. “We must have a public health system in place to combat multiple threats at the same time,” she writes. “Antibacterial resistance does not stop, so we have to face the challenge.”