MED-NERD

Antimicrobial Resistance and COVID-19

 
The Centers for Disease Control and Prevention (CDC) published a special report in 2022 discussing the COVID-19 and antimicrobial resistance in the U.S. and showed that antimicrobial-resistant infections are getting worse.

About 29,400 cases died from antimicrobial-resistant infections during the first year of COVID-19 pandemic with 40% of these infections were in hospitals. The report of CDC in 2019 showed at least 2.8 million antimicrobial-resistant infections still occurring in the U.S every year with about 35,000 deaths. 18 pathogens showing resistance were listed on the 2019  resistance threat report, the CDC is missing data for nine of these pathogens.

The CDC showed in the 2019 report a drop in the deaths from antimicrobial-resistant infections by 18% from 2012 to 2017 due to the national investment in prevention. The pandemic caused increase in the antimicrobial-resistance due to increased antibiotics use and less preventive measures. Implementation of preventive measures and programs can reduce the incidence of  resistant-infections.

COVID-19 increased the antimicrobial-resistant infections particularly in hospitals, patients on medical devices such as catheters and ventilators. From 2019 to 2020 and among 7 pathogens, resistant infections almost increased 15%. An analytic reported by CDC in 2021 showed higher rates of four types of  healthcare-associated infections (HAIs) in 2020 with higher rates of resistance to antibiotics.

Resistance to antifungal agents has also emerged in 2020 with 26% increase of fungal infections in hospitals, about 60% increase in Candida auris infections and other Candida species.

The CDC showed increasing resistant infections in the community from 2012 to 2017 before the pandemic. The national efforts and preventive measures against antimicrobial resistance including CDC investments in infection prevention and control and surveillance, also reduced the spread of COVID-19.

These efforts include the following:
-Health training programs such as "Project Firstline" to limit the spread of pathogens and infections.
-Supporting experts in prevention and control of infections.
-COVID-19 testing and the CDC Antimicrobial Resistance Laboratory Network (AR Lab Network) in 50 states to identify antimicrobial-resistant outbreaks.
-Supporting projects to control the threats of  infectious diseases and improve the public health outcomes.
-Developing tools for antibiotic use.

 
Antibiotics were prescribed to COVID-19 patients although antibiotics are not effective in viral infections like COVID-19 and the use of antibiotics varied throughout the pandemic. From March to October 2020, about 80% of the hospitalized COVID-19 patients received antibiotics. The use of antibiotics and antifungals may cause resistance if misused in people, animal, and plants. As a result of similarities between COVID-19 and the community-acquired pneumonia  and difficulty in distinguishing between them, about half of the hospitalized patients received ceftriaxone with azithromycin.

Compared to 2019, the respiratory illnesses and therefore the antibiotic use decreased in 2020. The antibiotic use increased again in 2021 but less than their use in 2019. From 2020 to December 2021, most antibiotics prescribed were azithromycin especially in COVID-19 cases. In April 2020, azithromycin use was 150% higher while in December 2020, it was 82% higher than in 2019. The overall antibiotic use in 2021 was 5% lower than in 2019 probably due to less  nursing home residents.

See: Antibiotic Resistance

See: The role of Environment and pollution in emergence of Antibiotic Resistance

 

Reference:

Antimicrobial resistance, centers for disease control and prevention (CDC)
https://www.cdc.gov/drugresistance/about.html