A recent report from the Department of Health and Human Services (HHS) highlights multiple interconnected factors that curtailed the capacity of United States hospitals to combat antimicrobial resistance (AMR) amid the COVID-19 pandemic.
Increased need of mechanical ventilation for critically ill patients, prolonged hospital stays, escalated caseloads, concurrent fear of undertreatment, absence of timely guidelines, an overburdened healthcare workforce focusing primarily on COVID-19 patients and scarce personal protective gear were amongst the myriad reasons cited by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) that led to the ‘large-scale disruption’ of US’ AMR mitigation efforts.
According to the study, the pandemic’s chaos resulted in a 15% surge in fatal hospital-acquired infections (HAIs) resistant to drugs and AMR-related deaths during the first year, compared to pre-pandemic figures. The authors urge that these insights be used to guide future initiatives aimed at curbing antibiotic overuse and drug-resistant infections in public health crises.
Exploring lessons learnt from the pandemic is key to refining our healthcare practices for the future. Policymakers must identify strategies that worked, failed, and ways to improve preparedness for upcoming challenges.
The factors outlined in the report correlate with the influx of critically ill patients in hospitals nationwide as the pandemic struck in early 2020. Increased HAI risk due to prolonged hospital stays and mechanical ventilation means that COVID-19 patients, especially those with potential bacterial co-infections, were likely given antibiotics. These measures presumably contributed to escalating AMR rates. Health care workers, already strained and experiencing burnout, had to concentrate on immediate patient care, making it challenging to sustain infection prevention control (IPC) efforts and Antimicrobial Stewardship Programs (ASPs) to curb AMR.
Further, the report revealed that multidrug-resistant infections were five times more likely to occur in COVID-19 wards compared to non-COVID-19 wards. Resource limitations, including limited lab capacity and a sample collection tools shortage, plus reliance on virtual communication platforms also hindered ASP activities.
Ultimately, the pandemic’s impact may require hospitals to revisit and modify IPC strategies and ASPs. However, with integrated preparation and stewardship, robust communication channels, and access to AMR-related data, guidance and diagnostics, healthcare systems can return to pre-pandemic AMR rates and mitigate future public health crises.