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the most severe suspected or confirmed COVID-19 cases , provided their use is regularly re-evaluated . However , we believe that even during a pandemic antibiotics should be used responsibly and sparingly , given concerns about the global supply chain of these valuable medicines potentially leading to antibiotics not being available for those who need them , the increased nursing workload associated with parenteral administration of antibiotics , and the many unintended negative long-term consequences associated with antibiotic overuse potentially leading to increased morbidity and mortality in the future … The COVID-19 pandemic puts a tremendous pressure on all healthcare professionals , not least on infectious disease and infection control specialists . We advocate that antibiotic stewardship principles will continue to be applied and promoted even in these challenging times .”
Founou , et al . ( 2021 ) point to the fact that antivirals and antibiotics were used in 93 percent of ICU patients and 100 percent in non-ICU patients , and that only 10 percent of patients had a secondary infection , suggesting thereby a 90 percent rate of antibiotic misuse . They observe , “ Considering that COVID-19 is caused by a virus that leads to a self-limiting infection in the majority of cases , antibiotic treatment implemented in COVID-19 patients , especially when secondary bacterial infections are not laboratory confirmed , are indicative of a well-recognized global pattern of antibiotic misuse that has contributed to AMR emergence and spread . Although it is currently uncertain whether COVID-19 or the ICU treatments it requires contribute to secondary bacterial infections , it is urgent that secondary infections such as bacterial pneumoniae in particular , be carefully ascertained before antibiotic administration . This is particularly important to reduce the misuse and overuse of antibiotics , and the subsequent emergence and escalation of AMR , across countries or regions while taking care of COVID-19 patients . This calls for a much wider use of bacterial identification and antibiotic susceptibility testing prior to antibiotic prescription .”
References :
Allen JG , Haas C and Marr LC . Opinion : We are over-cleaning in response to COVID-19 . The Washington Post . Dec . 11 , 2020 .
Anthes E . Has the Era of Overzealous Cleaning Finally Come to an End ? New York Times . April 8 , 2021 .
Centers for Disease Control and Prevention ( CDC ). Science Brief : SARS-CoV-2 and Surface ( Fomite ) Transmission for Indoor Community Environments . April 5 , 2021 .
Chen B , Han J , Dai H and Jiab P . Biocide-tolerance and antibiotic-resistance in community environments and risk of direct transfers to humans : Unintended consequences of community-wide surface disinfecting during COVID-19 ? Environ Pollut . 2021 Aug 15 ; 283 : 117074 . Published online April 3 , 2021 . doi : 10.1016 / j . envpol . 2021.117074
Founou RC , Blocker AJ , Noubom M , Tsayem C , Choukem SP , Van Dongen M and Founou LL . . The COVID-19 pandemic : a threat to antimicrobial resistance containment . Future Science . Vol . 7 , No . 8 . Published online June 9 , 2021 . https :// doi . org / 10.2144 / fsoa-2021-0012
Huttner BD , Catho G , Pano-Pardo JR , Pulcini C and Schouten J . COVID-19 : don ’ t neglect antimicrobial stewardship principles ! Clin Microbiol Infect . 2020 Jul ; 26 ( 7 ): 808-810 . Published online 2020 Apr 30 . doi : 10.1016 / j . cmi . 2020.04.024
Palmore TN and Henderson DK . Healthcare-Associated Infections in the Time of Pandemic
COVID-19 . Infect Control Hospital Epidemiol . Web . Aug . 25 , 2021 . Rosenberg E . Hygiene Theater or Hygiene Awareness ? Looking Beyond COVID-19 . Nov . 5 , 2020 . Thompson D . Deep Cleaning Isn ’ t a Victimless Crime . The Atlantic . April 13 , 2020 ( a ). Thompson D . Hygiene Theater Is a Huge Waste of Time : People are power scrubbing their way to a false sense of security . The Atlantic . 2020 ( b ). p . 1-8 .
Weiner-Lastinger LM , Pattabiraman V , Konnor R , Patel PR , Wong E , Xu SY , Smith B , Edwards JR and Dudeck MA . The impact of COVID-19 on healthcare-associated infections in 2020 ; A summary of data reported to the National Healthcare Safety Network . Infect Control Hosp Epidemiol . Web . Aug . 25 , 2021 .
Although the environment may not be a major driver of SARS-CoV-2 transmission at least in community / public settings , the role that environmental contamination play in nosocomial transmission in setting with heavy viral burdens and sick or physiologically vulnerable persons remain less understood .”
may be underrepresented in research because most are carried out in large university-based hospitals .”
Lesho , et al . ( 2021 ) comment that , “ Although the environment may not be a major driver of SARS- CoV-2 transmission at least in community / public settings , the role that environmental contamination play in nosocomial transmission in setting with heavy viral burdens and sick or physiologically vulnerable persons remain less understood . Perhaps another argument for meticulous cleaning of the environment of COVID-19 patients ’ rooms is the company that SARS-CoV-2 may keep during the pandemic ; such as C . difficle , MDR-Acinetobacter , or MDR-Candida that are known to persist in the environment longer than SARS-CoV-2 . Further studies are needed to understand how environmental contamination , especially cleaning effectiveness and thoroughness might contribute to SARS-CoV-2 acquisition .” And that , goes directly to the heart of the matter . The CDC ’ s newest guidance on environmental cleaning emphasizes that surfaces are a key component , explaining , “ The healthcare environment contains a diverse population of microorganisms . Surfaces contaminated with microorganisms can serve as reservoirs of potential pathogens . Many of these microorganisms are continuously shed or spread by direct skin contact onto surrounding environment surfaces . Contamination of surfaces , including high-touch surfaces in the room ( bedrails , over-bed tables , and call-buttons ) and reusable patient care equipment that is moved between rooms , can lead to transmission to the next patient who occupies the room or uses the same equipment , or contamination of the hands or clothing of healthcare personnel with transmission to other patients . Therefore , cleaning and disinfection of environmental surfaces is fundamental to reduce potential contribution to healthcare-associated infections . Inadvertent exposures to environmental opportunistic pathogens may result in infections with significant morbidity and / or mortality .”
A colonized or infected patient can lead to transmission of microorganisms through contaminated surfaces , which can serve as direct source