A recent study published in the JAMA Network Open, conducted by the Centers for Disease Control and Prevention (CDC), has examined the effects of the COVID-19 pandemic on hospital-onset antimicrobial-resistant infections. Antimicrobial resistance was found to be on the decline from 2012 till 2019. However, a sudden surge was observed during the acute COVID-19 pandemic years, 2020 and 2021.
The team, led by Hannah Wolford from the CDC’s Epidemiology, Research, and Innovations Branch, provided updated estimates of hospital-onset and community-onset antimicrobial-resistant infections caused by an identified group of six pathogens between the years 2012 and 2022. The CDC and the World Health Organization consider these pathogens regarding antibiotic resistance as high priority. The pathogens under focus included Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococcus (VRE), Carbapenem-resistant Enterobacteriaceae (CRE), Carbapenem-resistant Acinetobacter species (CRAsp), and Multidrug-resistant Pseudomonas aeruginosa (MDR P aeruginosa).
It was found that the resistance percentage either remained stable or decreased for these pathogens from 2012 to 2022. Speaking about the spike in resistance during the acute pandemic stage, Wolford pointed towards changes in healthcare utilization as a contributing factor. Increased admissions of high-risk COVID-19 patients and significantly ill patients without COVID-19 could have led to heightened rates of antimicrobial-resistant hospital-onset infections.
Populations most affected were among the ages of 55 to 74, with males more susceptible to an antimicrobial-resistant infection. Patient health trends also indicated an increase in average patient days per hospitalization from 2020 to 2022, suggestive of a rise in patients with high severity illness even as COVID-19 hospitalizations declined. The pandemic situation also strained infection control practices, and the decreased activities such as contact precautions for patients with some resistant pathogens and excess antimicrobial use monitoring may have contributed to increased resistance.
Wolford emphasized that investing in capacity to maintain robust infection control implementation, even during healthcare strains, along with developing innovative prevention strategies would protect against antimicrobial resistance in the future. Tracking national data on healthcare-associated infections and antimicrobial-resistant pathogens can pinpoint areas in need of improvement and increased focus on infection prevention and control.
Source: https://www.contagionlive.com/view/the-impact-of-the-pandemic-on-antimicrobial-resistance