the desperate need to save the lives of Covid patients during the first waves of the pandemic, coupled with shortages of hospital staff and protective equipment, caused a shocking turnaround against deadly superbugs, according to a new analysis by the US Centers for Disease Control and Prevention.
The report, released on July 12, synthesizes lab and hospital admission data to arrive at a stark conclusion: From 2019 to 2020, the number of antibiotic-resistant infections in hospitals and resulting deaths increased by at least 15 percent each. For some of the most difficult-to-treat pathogens, increases shot 26 percent to 78 percent. And those numbers are even worse than they seem, because in the years immediately preceding the pandemic, drug-resistant infections in US hospitals had been cut by nearly a third — meaning Covid had years of progress in reducing one of the most common health problems. persistent threats to patients.
“The pandemic created the perfect storm for this to happen,” said Arjun Srinivasan, a physician and associate director of the CDC’s healthcare-related infection prevention programs. “You had large numbers of patients who needed very advanced care, often in intensive care units – who needed central lines, needed urinary catheters, needed mechanical ventilation; all these increasing risks of infection, all these increasing risks of infections with antibiotic-resistant organisms.”
But medical experts say hiding in the startling trend — and it’s not present in the CDC report — is a surprising bright spot. Some US hospitals have been able to reduce their patients’ vulnerability to superbugs because they continued to support prevention programs they had set up before the pandemic began, and most importantly, because they ensured that those programs’ staff were not diverted to other tasks.
Any use of an antibiotic carries the potential to generate resistance, as bacteria adapt to defend themselves. So hospitals run programs, commonly known as antibiotic stewardship, that monitor which drugs are being used and reserve the most valuable compounds as last-report options. 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, or drug treatments suppress the immune system, or pathogens are carried between patients on coats or hands of staffers.
When masks and protective equipment came up short during the early waves, health workers couldn’t change their gear as they normally would. In flooded neighborhoods, they may have skipped safety steps to save lives. And as desperately ill patients overwhelmed ICs, clinicians are giving them antibiotics preventively — not to control Covid, as the virus is not affected by these drugs, but to ward off other infections. The CDC analysis shows that by 2020, nearly 80 percent of Covid patients received at least one antibiotic during their hospital stay, a much higher rate than normal.
Awkward forecasts over the past two years suggested this could happen. In the early months of the pandemic, several experts, including a former CDC director, published warnings that the widespread use of antibiotics in the first Covid patients lit the fuse of a time bomb. In March 2021, a project by the Pew Charitable Trusts predicted that resistance rates would certainly rise as so many Covid patients getting antibiotics† And by the end of that year, the evidence began to come in that they were right. A CDC analysis from last September found that Covid pressure on healthcare reverse years of progress in reducing infections in people who have already been hospitalized. In May, researchers from pharmaceutical giant Merck and medical technology company Becton Dickinson preliminary data showing that the number of drug-resistant infections in 271 US hospitals rose in 2020 and 2021 – in patients with and without Covid – compared to 2019.