The COVID pandemic accelerated the problem of antibiotic resistance

The use of antibiotics to treat COVID-19 patients increased and infection prevention and control practices were discontinued (Getty Images)

The problem of antimicrobial resistance increased before the pandemic due to self-medication by people, due to the prescription of inappropriate medications, and due to the administration of drugs in animals, among other reasons.

However, the crisis due to the public health emergency caused by COVID-19 in the world further influenced antibiotic resistance. According to a scientific study that evaluated the impact of 271 hospitals in the United States, patients hospitalized during the pandemic had higher rates of antibiotic-resistant bacterial infections.

The results of the work were presented in the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) that is taking place in Lisbon, Portugal.

In 2019, 1.2 million people worldwide had died from antibiotic-resistant infections, and this number is expected to increase tenfold by 2050. The COVID-19 pandemic has presented many challenges to appropriate antibiotic use and management.

Previous studies suggested that the emergence of the coronavirus was associated with infections secondary to antimicrobial resistance, possibly due to the increased use of antibiotics to treat COVID-19 patients and disruptions to infection prevention and control practices in overwhelmed health systems.

In 2019, 1.2 million people had died worldwide from antibiotic-resistant infections, and this number is expected to increase tenfold by 2050 (Getty)
In 2019, 1.2 million people had died worldwide from antibiotic-resistant infections, and this number is expected to increase tenfold by 2050 (Getty)

The study was conducted by Dr. Karri Bauer, from the pharmaceutical company MSD, and Dr. Vikas Gupta, from the medical technology company Becton Dickinson. They found that drug-resistant infections were significantly higher in cases that appeared in hospitals during the pandemic.

Although conclusive evidence is lacking, these indications underscore the importance of continuing to monitor the impact of COVID-19 on antimicrobial resistance rates, according to the researchers. So, To provide further evidence of the problem, they conducted a retrospective, multicenter cohort analysis of all adults (aged 18 years and older) admitted to 271 hospitals in the United States before and during the COVID-19 pandemic, who had spent at least one day in the hospital and they had a record of discharge or death.

Patients were classified according to when they were admitted: before the pandemic (from July 1, 2019 to February 29, 2020), or during the pandemic (from March 1, 2020 to October 30, 2021), and based on their COVID-19 status (with a positive result for the SARS-CoV-2 coronavirus defined by a positive PCR or antigen test within 7 days prior to admission or during hospitalization).

All admissions with at least one antimicrobial resistance infection, defined as a first positive culture for certain gram-negative or gram-positive antibiotic-resistant pathogens, were recorded.

Researchers evaluated resistance rates per 100 admissions before and during the COVID pandemic.and examined whether the drug-resistant infections were acquired in the community-based setting (defined as a culture collected less than 2 days after admission) or within the hospital (more than 2 days after admission).

A study was carried out on patients admitted to 271 hospitals in the United States before and during the COVID-19 pandemic (REUTERS / Mike Blake)
A study was carried out on patients admitted to 271 hospitals in the United States before and during the COVID-19 pandemic (REUTERS / Mike Blake)

In total, 1,789,458 patients were admitted to the hospital in the pre-pandemic period and 3,729,208 during the pandemic. The number of patients admitted to hospital with at least one antimicrobial resistance infection was 63,263 in the pre-pandemic period. Instead, it reached 129,410 during the pandemic.

The analyzes found that the resistance rate was 3.54 per 100 admissions before the pandemic and 3.47 per 100 admissions during the pandemic. However, patients who tested positive or negative for COVID-19 had higher levels of resistance than patients before the pandemic: 4.92 per 100 admissions and 4.11 per 100 admissions, respectively.

Regarding hospital infections, the resistance rate was 0.77 per 100 admissions before the pandemic and 0.86 per 100 admissions during the pandemic, and the highest was 2.19 per 100 admissions in patients with COVID-19. When community-derived infections are analyzed, the antimicrobial resistance rate was 2.76 per 100 admissions in the pre-pandemic period, and 2.61 per 100 admissions during the pandemic.

“These new data highlight the importance of closely monitoring the impact of COVID-19 on antimicrobial resistance rates,” said Dr. Bauer. Of particular concern is that antibiotic resistance has increased during the pandemic in both COVID-19 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before,” he warned.

The authors noted that further evaluation of the impact of the pandemic on antimicrobial resistance is needed: “As health care capacity remains top of mind, it will be vitally important to keep a pulse on the growing impact of drug-resistant infections”Gupta said.

Antibiotic resistance increased during the pandemic in both COVID-19 positive and negative patients (iStock)
Antibiotic resistance increased during the pandemic in both COVID-19 positive and negative patients (iStock)

“This type of data and surveillance will help health officials identify the resources needed to support antimicrobial stewardship programs, as well as support more detailed and sophisticated forecasting of future trends and outbreaks,” he said. Since the study they did was limited to US hospitals, they felt that an assessment of the impact of COVID-19 on antimicrobial resistance in other countries should also be done to monitor the problem.

as reported Infobae Last February, in Argentina, the forecast of an increase in the problem of antimicrobial resistance was advanced 10 years. Before the pandemic, there had been a 2% increase in the number of resistant bacteria affecting patients admitted to hospitals. In contrast, during the first year of the pandemic, there was a 30% increase in the number of resistant bacteria in hospitals.as reported to Infobae the non-profit organization Research in Antibiotic Resistance (INVERA), which brings together specialists in infectology and biochemistry.

“The situation of the problem of resistance to antimicrobials, such as antibiotics, worsened with the pandemic in Argentina. The problem means that patients can acquire infections with resistant bacteria that have a 10-fold higher risk of mortality compared to a heart attack “warned in dialogue with Infobae the infectious disease doctor Francisco Nacinovich, director of INVERA.

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