While the general focus has been on the immediate effects of the COVID-19 pandemic, the outbreak also reversed years of progress in the fight against antimicrobial resistance (AR), according to the Centers for Disease Control and Prevention (CDC).
In a report released this week – “COVID-19: U.S. Impact on Antimicrobial Resistance, Special Report 2022” – researchers determined that antimicrobial resistant infections and hospital deaths increased by 15 percent in 2020, the first year of the pandemic. Simultaneously, about 80 percent of patients hospitalized with COVID-19 received an antibiotic from March-October 2020.
“This setback can and must be temporary. The COVID-19 pandemic has unmistakably shown us that antimicrobial resistance will not stop if we let down our guard; there is no time to waste,” said Michael Craig, MPP, director of CDC’s Antibiotic Resistance Coordination & Strategy Unit. “The best way to avert a pandemic caused by an antimicrobial-resistant pathogen is to identify gaps and invest in prevention to keep our nation safe.”
The massive increase in infections was found among seven pathogens, though individual figures varied significantly. The most pronounced of these was carbapenem-resistant Acinetobacter, which saw a 78 percent increase over 2019 levels. Others, like the antifungal-resistant threat of Candida auris rose 60 percent, while multidrug-resistant Pseudomonas aeruginosa saw infections rise 32 percent and methicillin-resistant Staphylococcus aureus by 13 percent.
“We need to emphasize and expand the implementation of the effective prevention strategies that are already in CDC’s toolbox to all healthcare facilities,” said Denise Cardo, MD, Director of CDC’s Division of Healthcare Quality Promotion. “The 2021 launch of the Global AR Lab and Response Network and the Global Action in Healthcare Network is an example of how aggressively CDC is moving to combat antimicrobial resistance not only in the U.S. but in nearly 50 countries across the world. We made significant progress before the pandemic, and I’m confident that we will make significant progress going forward.”
Previously, infection rates had been falling – antimicrobial-resident infections decreased 27 percent between 2012 and 2017. However, in 2020, CDC experts concluded that Clostridioides difficile was the only healthcare-associated pathogen to improve. With antibiotic use surging along with difficulties in following infection prevention and control guidance, coupled with supply issues, resistant infection led to the deaths of more than 29,400 people throughout the United States. The CDC admitted those figures were likely higher due to data gaps caused by the pandemic.
Nearly 40 percent acquired such infections while in the hospital.
In its last comprehensive report, issued in 2019, the CDC estimated that more than 2.8 million antimicrobial-resistant infections occur annually in the United States.