In the midst of the COVID-19 pandemic, there has been a notable increase of 32% in the United States in hospital-acquired infections resistant to antimicrobials, with enduring rates currently at least 12% above pre-pandemic figures. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID), now rebranded as ESCMID Global, reveals that resistance to carbapenems – the ‘last-resort’ antibiotics for severe infections – remains at least 35% higher than before the pandemic. Especially impacted were hospitals experiencing voluminous patient surges amidst the pandemic, including larger institutions with elevated bed capacity. Despite steps forward in challenging antimicrobial resistance (AMR), according to a significant study led by Dr. Christina Yek of the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), hospital-acquired AMR rates are still prominently above pre-pandemic levels.
The study, highlighted at this year’s ESCMID Global Congress, underscores the urgent need to understand and address the Persistence of hospital-onset infections, particularly those induced by gram-negative resistant organisms. It is estimated that AMR is the cause of at least 35,000 annual deaths in the US and 1.27 million worldwide. To better understand the concealment of AMR in US hospitals, researchers examined trends in AMR infection rates among adults in 120 US hospitals before, during, and after the pandemic. These analyses revealed an overall 6.3% increase in AMR infections during the pandemic, primarily fuelled by a sharp rise in hospital-acquired AMR infections, which soared by at least 32%. The escalation was most noticeable in hospital-acquired infections resistant to commonly prescribed antibiotics called carbapenems.
With reduced societal mobility due to pandemic restrictions, community-acquired Methicillin-resistant Staphylococcus aureus (MRSA) infections surprisingly declined by 10% and 19% during and after the pandemic, respectively. Hospitals facing deep surges in severely ill COVID-19 patients witnessed the largest increment in hospital-acquired AMR infections, a rising trend seen more so in larger hospitals with greater bed capacity. Overall AMR incidence post-pandemic has nearly realigned with pre-pandemic rates, however, hospital-acquired AMR infections remained 13% above pre-pandemic levels in December 2022, primarily due to the persistence of gram-negative pathogen infections resistant to most available first-line antibiotics. In conclusion, while it might seem that AMR levels have nearly returned to pre-pandemic levels, the high levels of hospital-acquired AMR infections cast serious alarms among US healthcare facilities, necessitating proactive action.