The pandemic has fueled a superbug wave. Can the medicine recover?

The Desperate Need Saving the lives of Covid patients during the first waves of the pandemic, combined with shortages of hospital staff and protective equipment, led to a shocking reversal in the trend against deadly superbugs, according to a new analysis from the US Centers for Disease Control and Prevention.

The report, published on July 12, synthesizes laboratory and hospital admissions data and comes to a grim conclusion: From 2019 to 2020, the number of antibiotic-resistant infections in hospitals and the resulting deaths each rose by at least 15 percent. In some of the most difficult-to-treat pathogens, increases rose 26 percent to 78 percent. And those numbers are even worse than they seem, because in the years immediately leading up to the pandemic, drug-resistant infections in hospitals across the US had fallen by almost a third – meaning Covid has undone years of progress in cutting back one of the world’s greatest health care services persistent threats to patients.

“The pandemic has created the perfect storm for this,” says Arjun Srinivasan, physician and associate director of the CDC’s health-related infection prevention programs. “They had a large number of patients who needed very advanced care, often in intensive care units — they needed central lines, urinary catheters, mechanical ventilation; all these increasing risks of infection, all these increasing risks of infection with antibiotic-resistant organisms.”

But medical experts say that behind the troubling trend — and that’s not included in the CDC’s report — lies a surprising bright spot. Some U.S. hospitals have been able to reduce their patients’ susceptibility to superbugs by continuing to support prevention programs they started before the pandemic began, and particularly by not allowing staff at those programs to be distracted from other tasks .

Any use of an antibiotic has the potential to provoke resistance as bacteria adapt to defend themselves. Therefore, hospitals run programs commonly known as antibiotic stewardship that monitor which drugs are used and reserve the most valuable compounds as options for last-minute reporting. At the same time, they maintain infection prevention teams to protect patients from infections that can arise when medical devices accidentally introduce bacteria into the body, drug treatments suppress the immune system, or pathogens are carried between patients on staff’s gowns or hands.

When masks and protective gear ran out during the first waves, healthcare workers were unable to swap out gear as usual. In flooded stations, they may have skipped safety steps to try to save lives. And as critically ill patients overwhelmed intensive care units, clinicians gave them antibiotics pre-emptively — not to control Covid, as the virus isn’t affected by those drugs, but to ward off other infections. The CDC analysis finds that in 2020, nearly 80 percent of Covid patients received at least one antibiotic during their hospitalization, a far higher percentage than normal.

Troubled predictions over the last two years indicated that this could happen. In the early months of the pandemic, several experts, including a former CDC director, issued warnings that the widespread use of antibiotics in the earliest Covid patients lit the fuse of a time bomb. In March 2021, a Pew Charitable Trusts project predicted that resistance rates would surely increase because so many Covid patients were receiving antibiotics. And towards the end of the year, evidence began to come in that they were right. A CDC analysis last September found that Covid pressure on healthcare has reversed years of progress in reducing infections in people already hospitalized. In May, researchers from pharmaceutical giant Merck and medical technology company Becton Dickinson presented preliminary data showing that rates of drug-resistant infections in 271 US hospitals increased in 2020 and 2021 – among patients with and without Covid – compared to 2019.

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