People hospitalised during the pandemic both for Covid and other conditions have a higher rate of antibiotic-resistant bacterial infections compared to patients hospitalised before the pandemic, according to a study. An estimated 1.2 million people worldwide died in 2019 from antibiotic-resistant infections, and this number is predicted to increase ten-fold by 2050. There have been studies reporting that the pandemic was associated with antimicrobial resistance (AMR) secondary infections, possibly due to the increase in the use of antibiotics to treat Covid-19 patients and disruptions to infection prevention and control practices in overwhelmed health systems. The study, presented at this year's European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) being held in Portugal, evaluated the pandemic's impact on antimicrobial resistance (AMR) in 271 hospitals across the US.
The researchers assessed AMR rates per 100 hospital admissions before and during the Covid pandemic, and examined whether drug-resistant infections were acquired in the community-onset setting (defined as a culture collected less than two days after admission) or in the hospital-onset setting (more than two days after admission). 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 the hospital with at least one AMR infection was 63,263 in the pre-pandemic period and 129,410 during the pandemic. Patients who tested positive or negative for Covid had higher levels of AMR than patients before the pandemic, 4.92 per 100 admissions and 4.11 per 100 admissions, respectively.
For hospital-associated infections, the AMR rate was 0.77 per 100 admissions before the pandemic and 0.86 per 100 admissions during the pandemic, and highest at 2.19 per 100 admissions in patients with Covid-19. When looking at community-onset infections, the AMR 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 Karri Bauer from the US pharmaceutical company Merck. "It is particularly worrying that antibiotic resistance has been rising during the pandemic in both SARS-CoV-2 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before," he added.