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A widely overlooked risk , however , lies in the fact that massive loads of chemical disinfectants are being used on a routine basis in community settings , including many public places with high user occupancy or foot traffic , to reduce the virus spread or as a precautionary measure .
“ Basic infection control practices must be hardwired into practice so that they are less vulnerable when the health care system is stressed ,” the editorial concluded . “ One approach might be to designate clinical staff to be added to the hospital epidemiology team to allow for rapid expansion of effort to support a pandemic response .” Palmore and Henderson ( 2021 ) continue , “ As pointed out by Weiner-Lastinger et al ., resiliency in the healthcare epidemiology team is essential . In the absence of additional resources , in similar circumstances , one might anticipate similar outcomes .”
APIC president Ann Marie Pettis , BSN , RN , CIC , FAPIC , calls this new CDC data “ quite troubling and must serve as a call to action .” She adds , “ As a nation we must take significant efforts to bolster our infection prevention and control programs throughout the healthcare continuum . The new report highlights the need for healthcare facilities to strengthen their infection prevention programs and support them with adequate resources so that they can handle emerging threats to public health , while at the same time ensuring that gains made in combatting HAIs are not lost .”
Pettis continues , “ The unfortunate reality is that in one year we lost nearly a decade of progress against HAIs like central line-associated bloodstream infections , catheter-associated urinary tract infections , methicillin-resistant Staphylococcus aureus ( MRSA ), and ventilator-associated events . We now have an opportunity to use this data and take action to invest in our public health infrastructure , expand our nation ’ s infection prevention and control workforce , and put infection preventionists – specialists who are trained and certified to prevent infections — at the center of these efforts . APIC is calling on healthcare facilities to assess their infection prevention programs by looking at the care and services they provide and determining the appropriate level of personnel and resources necessary to protect patients and healthcare workers . Facility-wide infection prevention programs are critical and require adequately staffed , trained , and resourced infection prevention and control departments . APIC also calls on federal and state governments to provide funding to help support healthcare facilities across the continuum of care to ensure that there is adequate surge capacity so that infection prevention and control measures will endure when stressed by future pandemics and disease outbreaks .”
Triggering Resistance
Returning to the aforementioned second issue of resistance , Chen , et al . ( 2021 ) acknowledge the danger : “ Concerning antimicrobial resistance , much of the discussion in recent literature has revolved around the prevalent use and sometimes misuse of antibiotics in the current pandemic . Given the fact that patients diagnosed with COVID-19 are often prescribed with antibiotics for treating bacterial co-infections , some warned that excessive use of antibiotics – sometimes even on patients showing no symptom of bacterial infection – can exacerbate the emergence of antibiotic resistance . A widely overlooked risk , however , lies in the fact that massive loads of chemical disinfectants are being used on a routine basis in community settings , including many public places with high user occupancy or foot traffic , to reduce the virus spread or as a precautionary measure . In areas with persisting spread of COVID-19 , such practices have been put in place for months with no ending yet in sight ( CDC , 2021 ). In this context , antimicrobial resistance emerged from regularly disinfected surfaces and environments in those immediate surroundings may become a realistic risk which has been barely addressed in current regulatory guidelines or scholarly discussions revolving around COVID-19 .”
Chen , et al . ( 2021 ) add , “… community-related environments have much closer links with humans , where antimicrobial resistant pathogens emerged under current circumstances could pose risks of direct transfers to humans via contacting surfaces , touching objects , or similar activities . Such risks are not of a speculative nature : ample evidence showed that when exposed to those commonly used biocidal agents , many types of bacterial pathogens could develop increased tolerance and through similar mechanisms , acquire resistance to antibiotics . In July 2020 , a group of scientists at WHO proposed that the short- and longterm impact of the widespread use of biocides for environmental and personal disinfection , including resistance to antimicrobials , should be included in the current research agenda .”
Scientists are sounding the alarm . Lu and Guo ( 2021 ) expressed their concerns around the escalating use of antimicrobials including disinfectants , sanitizers and antiseptics during COVID-19 , and warned about the potential of disinfectant-facilitated bacterial acquisition of antimicrobial resistance .
“ Current expertise and studies indicate that overuse of biocides can lead to an issue or resistance in regard to cleaning and disinfection ,” affirms microbiologist Rodney Rohde , PhD , MS , SM ( ASCP ) CM SVCM , MBCM , FACSc , chair and professor of the Clinical Laboratory Science Program at Texas State University . “ Evidence suggests a connection between disinfectant use and antibiotic resistance as suggested in laboratory and real-life settings . For COVID-19 , the most commonly used disinfecting agents are quaternary ammonium compounds , hydrogen peroxide , sodium hypochlorite and ethanol , which account for two-thirds of the active ingredients in current EPA-approved disinfectant products for the novel coronavirus . Tolerance to each