The spread of drug-resistant infections escalated during the coronavirus pandemic, killing nearly 30,000 people in 2020 and undoing much of recent progress in containing the spread of so-called superbugs, according to an analysis by the Centers for Disease Control and Prevention.
Deaths from infections impermeable to antibiotics and antifungals rose 15 percent in the first year of the pandemic compared to 2019, federal health officials found. Much of the surge was linked to the havoc the coronavirus had wreaked, as doctors and nurses struggled to treat waves of critically ill patients whose illness they didn’t fully understand before vaccines and treatments were widely available.
About 40 percent of the deaths occurred in hospitalized patients, with the rest in nursing homes and other health-care facilities, the CDC report said. According to the study, many frontline hospital workers mistakenly administered antibiotics for viral lung infections that failed to respond to such drugs. Many of the sickest patients have spent weeks or months in intensive care units, increasing the likelihood of drug-resistant germs entering their bodies through IV lines, catheters and breathing tubes.
The death toll is likely much higher, federal health officials said, because public health labs, which normally track drug-resistant infections, have been swamped during the pandemic, leading to significant data gaps for many of the most dangerous pathogens.
The CDC said the outbreaks of drug-resistant infections were likely fueled by a nationwide shortage of face masks, gloves and gowns — the vital armor that protects health workers and helps limit the spread of pathogens as they travel from room to room. Due to staff shortages and overwhelmed wards in many hospitals, infection control specialists have often been reassigned to provide basic care to patients instead of performing their usual duties of promoting the appropriate use of antibiotics, hand washing and other safety measures, the report said.
“These setbacks can and must be temporary,” said Dr. Rochelle P. Walensky, the director of the CDC, in a statement accompanying the report. “The Covid 19 pandemic has made it clear – prevention is precaution. We must prepare our public health systems to combat multiple threats simultaneously.”
Federal officials have been particularly concerned about the increasing spread of some of the country’s most dangerous pathogens. They found a 78 percent increase in infections with Acinetobacter, a bacterium resistant to the antibiotic carbapenem that is common among ICU patients. and a 60 percent increase in Candida auris, a deadly fungus that commonly afflicts nursing homes and long-term care facilities.
The analysis highlights what public health experts have long called a slowly advancing pandemic. More than 700,000 people around the world die each year from infections that no longer respond to antimicrobial drugs, and health experts warn that without a concerted effort to stop overuse, the death toll could reach 10 million by 2050 of antibiotics and to develop new medicines.
Antimicrobial resistance occurs when bacteria and fungi mutate to outsmart the drugs designed to defeat them. This evolutionary process is inevitable, but the more these drugs are administered to humans and livestock, the more likely resistance will emerge.
Nearly a third of all antibiotics are misprescribed, often for respiratory illnesses like the common cold, which are caused by viruses, according to the CDC. The problem appears to have grown during the pandemic: Eighty percent of hospitalized Covid patients received antibiotics between March and October 2020, the agency found.
The CDC’s findings stand in stark contrast to previous reports that have seen slow but steady progress in tackling the hospital-acquired infections that kill 35,000 Americans and sicken 2.8 million each year. Between 2012 and 2019, drug-resistant infections fell by 18 percent, according to the agency’s 2019 report, which found improvements were associated with increased investment in programs to reduce inappropriate antibiotic use in hospitals.
The latest report confirmed what many healthcare workers and public health experts had suspected based on anecdotal evidence and a handful of previous studies.
“The extent to which it has gotten really alarming is really alarming,” said David Hyun, director of the Antibiotic Resistance Project at the Pew Charitable Trusts, a nongovernmental organization. “It also underscores the urgency that we really need to focus and reinvest in efforts to address this public health issue.”