The Hidden Cost of COVID-19: Focus on Antimicrobial Resistance in Bloodstream Infections

Abstract

Antibiotic resistance is one of the greatest growing public health threats and a worldwide priority. According to the WHO, drug-resistant diseases may cause 10 million deaths a year by 2050 and have a substantial impact on the global economy, driving up to 24 million people into poverty. The ongoing COVID-19 pandemic has exposed the fallacies and vulnerability of healthcare systems worldwide, displacing resources from existing programs and reducing funding for antimicrobial resistance (AMR) fighting efforts. Moreover, as already seen for other respiratory viruses, such as flu, COVID-19 is often associated with superinfections, prolonged hospital stays, and increased ICU admissions, further aggravating healthcare disruption. These events are accompanied by widespread antibiotic use, misuse, and inappropriate compliance with standard procedures with a potential long-term impact on AMR. Still, COVID-19-related measures such as increasing personal and environmental hygiene, social distancing, and decreasing hospital admissions could theoretically help the AMR cause. However, several reports have shown increased antimicrobial resistance during the COVID-19 pandemic. This narrative review focuses on this “twindemic”, assessing the current knowledge of antimicrobial resistance in the COVID-19 era with a focus on bloodstream infections and provides insights into the lessons learned in the COVID-19 field that could be applied to antimicrobial stewardship initiatives.

Multidrug-Resistant ESKAPE Pathogens in a Romanian Secondary-Care Hospital during the COVID-19 Pandemic

“…The WHO report on antimicrobial resistance (AMR) surveillance in the European Region highlighted a decrease in E. coli isolates in 2020 compared to previous years, attributed to reduced non-COVID-19 care activities and a decline in AMR surveillance vigilance [11,12]. Unlike other countries in the European Region that reported an increase in the frequency of commonly associated healthcare pathogens, such as Acinetobacter baumannii and Enterococcus faecium, these issues were not observed in our study.…”

“…Moreover, the hospital low bacteriological charge could be explained by the reorganization of COVID-19 support wards and disturbed specific activities of specialized departments, additionally to the frequent difficulties in properly sampling bacteriological specimens from COVID-19 wards or the limited recommendations of bacteriological investigations, according to the protocols for diagnosing the viral pandemic infection. The challenges posed by the COVID-19 pandemic for Antibiotic Stewardship and for the activity of the Infection, Prevention and Control of Infections department in hospitals, were determined by the increase in the number of critical cases, a decrease in infection control vigilance, insufficient specialized staff resources, diminished access to microbiological investigations in favour of virological investigations, and the lack of diagnostic and treatment guidelines in the early stages of the pandemic infection [1,10,11].…”

Lipid nanoparticles based on natural matrices with activity against multidrug resistant bacterial species

“…These bacterial species were selected because they are drug multi-resistant, including the resistance to antibiotics considered the last therapeutic choice. Consequently, they are the most prevalent species of the most of infections described in clinics, increasing hospital costs and mortality rates ( Tacconelli et al., 2018 ; Osme et al., 2020 ; World Health Organization, 2021 ; Murray et al., 2022 ; Wang et al., 2022 ; Micheli et al., 2023 ; Yao et al., 2023 ). Firstly, a screening of 14 natural oils was carried out to select those with the most promising in vitro antibacterial activity as the structural and bioactive excipient in the preparation of different NLC formulations.…”

An ultra-sensitive SARS-CoV-2 antigen optical biosensor based on angiotensin converting enzyme 2 (ACE-2) functionalized magnetic-fluorescent silica nanoparticles

“…We further investigated the detection of SARS-CoV-2 in real biological sample, the human blood serum. Recent reports have stated that SARS-CoV-2 infection in the blood stream may lead to abnormal blood clotting [55][56][57]. The decrease of maximum intensity at 588 nm was calculated to be 84.3%, which is comparable to the detection of the antigen in PBS buffer as shown in figure 8(b).…”