infection prevention
Hospitalization-Related Infections Grew 15 Percent From 2019 to 2020 , Drives AMR
The COVID-19 pandemic has unmistakably shown us that antimicrobial resistance will not stop if we let down our guard ; there is no time to waste .
The best way to avert a pandemic caused by an antimicrobialresistant pathogen is to identify gaps and invest in prevention to keep our nation safe .”
A new report from the Centers for Disease Control and Prevention ( CDC ) indicates that years of progress combating antimicrobial resistance ( AR ) has been undone by the COVID-19 pandemic .
The report , COVID-19 : U . S . Impact on Antimicrobial Resistance , Special Report 2022 , concludes that the threat of antimicrobial-resistant infections is not only still present but has been exacerbated by resistant hospital-onset infections and deaths increasing at least 15 percent during the first year of the pandemic .
Michael Craig , MPP , director of CDC ’ s Antibiotic Resistance Coordination & Strategy Unit , says the setback can be temporary . “ The COVID-19 pandemic has unmistakably shown us that antimicrobial resistance will not stop if we let down our guard ; there is no time to waste ,” Craig said in a statement . “ The best way to avert a pandemic caused by an antimicrobial-resistant pathogen is to identify gaps and invest in prevention to keep our nation safe .”
In the report , CDC analyzed the state of antimicrobial resistance in the United States immediately following the 2020 peaks of the COVID-19 pandemic . The data show an alarming increase in resistant infections starting during hospitalization , growing an overall 15 percent from 2019 to 2020 among seven pathogens . Increases in specific pathogens included :
• carbapenem-resistant Acinetobacter – 78 percent increase in infections
• multidrug-resistant Pseudomonas aeruginosa – 32 percent increase in infections
• vancomycin-resistant Enterococcus ( VRE ) – 14 percent increase in infections
• methicillin-resistant Staphylococcus aureus ( MRSA ) – 13 percent increase in infections
Antifungal-resistant threats rose in 2020 , too , including Candida auris — which increased 60 percent overall — and Candida species ( excluding Candida auris ), with a 26 percent increase in infections in hospitals . By comparison , in a 2019 report , significant national reductions in hospitals were celebrated , where antimicrobial-resistant infections fell by 27 percent from 2012 to 2017 ; data show these reductions continued in hospitals until the pandemic began . Clostridioides difficile is the only healthcare-associated pathogen to improve in 2020 , likely driven in part by changes in healthcare-seeking behavior .
In U . S . hospitals , CDC data show significant surges in antibiotic use and difficulty in following infection prevention and control guidance , which are key to preventing antimicrobial-resistant infections and their spread . During the pandemic , hospitals experienced personal protective equipment ( PPE ) supply challenges , staffing shortages , and longer patient stays . Hospitals also treated sicker patients who required more frequent and longer use of medical devices like catheters and ventilators . The impact of the pandemic likely resulted in an increase of healthcare-associated , antimicrobial-resistant infections .
During the first year of the pandemic , more than 29,400 people died from antimicrobial-resistant infections commonly associated with healthcare . Of these , nearly 40 percent got the infection while they were in the hospital . The total national burden of deaths from AR may be much higher , but data gaps caused by the pandemic hinder that analysis . CDC says it has limited data for the spread of antimicrobial-resistant infections in the community ; many clinics and healthcare facilities had limited services , served fewer patients , or closed their doors entirely in the face of challenges from COVID-19 . Data are unavailable or delayed for nine of the 18 pathogens listed in CDC ’ s 2019 Antibiotic Resistance Threats Reports .
In the 2019 report , the last year comprehensive healthcare and community data were available to calculate , CDC estimated that more than 2.8 million antimicrobial-resistant infections occur in the U . S . each year , with more than 35,000 people dying as a result .
Historic progress made in antibiotic prescribing was reversed as well during the pandemic , experts say . Antibiotics were often the first option given to treat those who presented with pneumonia-like symptoms of fever and shortness of breath even though this often represented the viral illness of COVID-19 , for which antibiotics are not effective . From March 2020 to October 2020 , almost 80 percent of patients hospitalized with COVID-19 received an antibiotic . While some of this prescribing can be appropriate when risks for related bacterial or fungal infections are unknown , this high level of prescribing can also put patients at risk for side effects and create a pathway for resistance to develop and spread .
Despite the pandemic , in 2020 , more than 90 percent of U . S . hospitals had an antibiotic stewardship program aligned with CDC ’ s Core Elements of Hospital Antibiotic Stewardship — which may have contributed to the reduction in Clostridioides difficile infections .
During the pandemic , many antimicrobial resistance programs contributed to stopping the spread of COVID-19 . For example , CDC ’ s AR Solutions Initiative