Impact of the COVID-19 pandemic on the surveillance of antimicrobial resistance

Abstract

Background The impact of the coronavirus disease (COVID-19) pandemic on antimicrobial resistance (AMR) is a major concern. Aim To compare the number of patients and isolation rate of antimicrobial-resistant bacteria before and after the beginning of the COVID-19 pandemic using the comprehensive national surveillance data. Methods We utilized comprehensive surveillance data, collected in the Japan Nosocomial Infections Surveillance program, which included a total of 16.7 million samples of 5.9 million tested patients from >1,300 hospitals. We compared the number of patients and isolation rate of five bacteria between 2019 and 2020, including antimicrobial-susceptible and -resistant bacteria of Staphylococcus aureus , Streptococcus pneumoniae , Escherichia coli, Klebsiella pneumoniae , and Pseudomonas aeruginosa . Findings The number of patients and isolation rate of S. aureus and methicillin-resistant S. aureus decreased slightly; those of S. pneumoniae and penicillin-resistant S. pneumoniae decreased by 60%; and those of third-generation cephalosporin-resistant K. pneumoniae increased. The isolation rate of the remaining bacteria apparently increased, although the number of patients decreased. This was due to a substantial decrease in the total number of tested patients (the denominator of the isolation rate), which was larger than that of the number of patients (the numerator of the isolation rate). Consistent results were obtained when the same data were re-aggregated using the procedure of the World Health Organization Global Antimicrobial Resistance Surveillance System, demonstrating the general importance of this problem. Conclusion Surveillance data during the COVID-19 pandemic must be carefully interpreted based on examination of the numerator, denominator and background factors that affect the denominator.

Impact of the COVID-19 pandemic on multidrug-resistant hospital-acquired bacterial infections

“…Our data were from a single hospital based in Lombardy, an area where the prevalence of MDR bacteria was very high even before COVID-19 pandemic. Either of these factors may partially explain the differences between our results and those from other geographical areas, where the incidence of MDR HAI declined during COVID-19 period [ 4 , 6 , 8 ]. Nevertheless, our data show the potential for MDR bacteria to cause infections in COVID-19 patients.…”

“…In particular, they found a significant increase in Acinetobacter baumannii infections in 2020 compared to 2019, and a consequent increase in the empiric prescription of polymyxins. To date, the impact of COVID-19 pandemic on the occurrence of multidrug-resistant (MDR) bacteria has been evaluated in several reports [ [2] , [3] , [4] , [5] ]; in particular, the longer duration of antimicrobial therapy for the management of respiratory complications of COVID-19 infection may have a devastating impact on infection control, leading to possible outbreaks of MDR bacteria in hospitals. Further, data on the increased incidence of specific MDR Enterobacterales (e.g.…”

Rational use of antibiotics during the COVID-19 pandemic

“…Bakterije kao što su Staphylococcus aureus, MRSA, Streptococcus pneumoniae i Streptococcus pneumoniae rezistentan na penicilin, izolovane su u manjem broju tokom pandemije. Smatra se da su za ovo odgovorni: pojačana upotreba sredstava za dezinfekciju i pranje ruku, smanjenje socijalnih kontakata, nošenje maski, kao i povremeno zatvaranje školskih ustanova [37,38]. Sa druge strane, bakterije kao što su Escherichia coli i Klebsiella pneumoniae (posebno Escherichia coli rezistentna na treću generaciju cefalosporina kao i Klebsiella pneumoniae rezistentna na treću generaciju cefalosporina) izolovane su u većem broju, i takođe su imale proširen spektar antibiotske rezistencije tokom pandemije [37].…”

“…Bacteria such as Staphylococcus aureus, MRSA, Streptococcus pneumoniae, and penicillin-resistant Streptococcus pneumoniae have been isolated in smaller numbers during the pandemic. It is believed that the increased use of disinfectants, hand washing, the limitation of social contacts, wearing face masks, as well as the occasional closing of schools are responsible for this [37,38]. On the other hand, bacteria such as Escherichia coli and Klebsiella pneumoniae (especially Escherichia coli and Klebsiella pneumoniae resistant to 3 rd generation cephalosporins) have been isolated in greater percentages and have also demonstrated an extended spectrum of antibiotic resistance during the pandemic [37].…”

Spatiotemporal patterns and progression of the Delta variant of COVID-19 and their health intervention linkages in Southeast Asia

“…As a matter of fact, many previous studies were also faced with a shortage or loss of available data (i.e., insufficient pediatrics data) [54][55][56]. Moreover, insufficient knowledge of the data or dynamics would lead to invalidity and unreliability of responses to COVID-19 [57]. Therefore, we strongly suggest that public health authorities should disclose more representative and reliable data [58,59].…”