Impact of the COVID-19 pandemic on the surveillance, prevention and control of antimicrobial resistance: a global survey

Abstract

Objectives The COVID-19 pandemic has had a substantial impact on health systems. The WHO Antimicrobial Resistance (AMR) Surveillance and Quality Assessment Collaborating Centres Network conducted a survey to assess the effects of COVID-19 on AMR surveillance, prevention and control. Methods From October to December 2020, WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) national focal points completed a questionnaire, including Likert scales and open-ended questions. Data were descriptively analysed, income/regional differences were assessed and free-text questions were thematically analysed. Results Seventy-three countries across income levels participated. During the COVID-19 pandemic, 67% reported limited ability to work with AMR partnerships; decreases in funding were frequently reported by low- and middle-income countries (LMICs; P < 0.01). Reduced availability of nursing, medical and public health staff for AMR was reported by 71%, 69% and 64%, respectively, whereas 67% reported stable cleaning staff availability. The majority (58%) reported reduced reagents/consumables, particularly LMICs (P < 0.01). Decreased numbers of cultures, elective procedures, chronically ill admissions and outpatients and increased ICU admissions reported could bias AMR data. Reported overall infection prevention and control (IPC) improvement could decrease AMR rates, whereas increases in selected inappropriate IPC practices and antimicrobial prescribing could increase rates. Most did not yet have complete data on changing AMR rates due to COVID-19. Conclusions This was the first survey to explore the global impact of COVID-19 on AMR among GLASS countries. Responses highlight important actions to help ensure that AMR remains a global health priority, including engaging with GLASS to facilitate reliable AMR surveillance data, seizing the opportunity to develop more sustainable IPC programmes, promoting integrated antibiotic stewardship guidance, leveraging increased laboratory capabilities and other system-strengthening efforts.

Decrease in community antibiotic consumption during the COVID-19 pandemic, EU/EEA, 2020

“…This has been attributed to the non-pharmaceutical interventions put in place as a response to the pandemic, including physical distancing, respiratory etiquette, face masks and promotion of hand hygiene [ 12 ]. In addition, the decrease in community antibiotic consumption may have resulted from a decrease in the number of primary care consultations that were due to community lockdowns and reduced access to primary care during the period [ 2 , 8 , 9 ], which would most probably mainly result in fewer antibiotic prescriptions for mild and self-limiting infections. However, there was a more than 20-fold inter-country variation in the size of the decrease in community antibiotic consumption between 2019 and 2020.…”

“…The ongoing coronavirus disease (COVID-19) pandemic has since its start in early 2020 affected societies worldwide. In addition to the direct COVID-19-related morbidity and mortality, secondary effects on general communicable disease epidemiology and healthcare system delivery have also been reported [ 1 , 2 ].…”

Antibiotic Prescribing Trends in Belgian Out-of-Hours Primary Care during the COVID-19 Pandemic: Observational Study Using Routinely Collected Health Data

“…Bacterial co-infection is uncommon in patients admitted to hospital with community-acquired COVID-19; therefore, prudent use of antibiotics remains important, even when suspecting a COVID-19 infection [ 22 ]. Worldwide antimicrobial stewardship programs and antimicrobial resistance surveillance has been impacted [ 44 ].…”

The challenge of preventing and containing outbreaks of multidrug-resistant organisms and Candida auris during the coronavirus disease 2019 pandemic: report of a carbapenem-resistant Acinetobacter baumannii outbreak and a systematic review of the literature

“…Another particular feature of the COVID-19 pandemic was the disruption of MDRO screening surveillance programs due to constraints of personnel and financial resources. In a survey performed by the Global Antimicrobial Resistance and Use Surveillance System, 64% of the 68 participating countries reported a decrease in the number of requested screening cultures during the pandemic [42]. It remains to be seen how this influences the spread of antimicrobial resistance in the long-term.…”