The silent pandemic: Emergent antibiotic resistances following the global response to SARS-CoV-2

Mahoney, Andrew R.; Safaee, Mohammad Moein; Wuest, William M.; Furst, Ariel L.

doi:10.1016/j.isci.2021.102304

Cited by 131 publications

(108 citation statements)

References 58 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…High empiric use of broad-spectrum antibiotics observed for COVID-19 patients is heightening concern that antibiotic overuse during the COVID-19 pandemic will exacerbate the problem of antimicrobial resistance in microorganisms of clinical significance into the future. ( 36 , 37 , 38 ) The review by Rawson et al found that 72% of COVID-19 patients had received antibacterial therapy and that recorded agents tended to be broad-spectrum antibiotics prescribed empirically in both critical and non-critical settings. ( 10 ) A meta-analysis by Langford and colleagues of 3,338 hospitalised and critical COVID-19 patients across 24 studies reported that a majority of COVID-19 patients received antibiotics (71.9%, 95% confidence interval (CI): 56.1-87.7%).…”

Section: Multi-drug Resistance and Antimicrobial Stewardshipmentioning

confidence: 99%

The interface between COVID-19 and bacterial healthcare-associated infections

O'Toole

2021

Clinical Microbiology and Infection

129

View full text Add to dashboard Cite

Background A wide range of bacterial infections occur in COVID-19 patients, particularly, in those with severe coronaviral disease. Some of these are community acquired co-infections. Objective To review recent data which indicate the occurrence of hospital-onset bacterial infections, including with antibiotic-resistant isolates, in COVID-19 patients. Sources Using PubMed, the literature was searched using terms including: “COVID-19”; “SARS-CoV-2”; “bacterial infection”; “healthcare-associated infection”; “antibiotic resistance”; “antimicrobial resistance”; “multi-drug resistance”; “ Streptococcus ”; “ Staphylococcus ”; “ Pseudomonas ”; “ Escherichia ”; “ Klebsiella ”; “ Enterococcus ”; “ Acinetobacter ”; “ Haemophilus ”; “MRSA”; “VRE”; “ESBL”; “NDM-CRE”; “CR-Ab”; “VRSA”; “MDR”. Content There is a growing number of reports of bacterial infections acquired by patients with severe COVID-19 after hospital admission. Antibiotic-resistant pathogens found to cause healthcare-associated infections (HAIs) in COVID-19 patients include Methicillin-Resistant Staphylococcus aureus (MRSA), New Delhi Metallo-β-lactamase-producing Carbapenem-Resistant Enterobacterales (NDM-CRE), Carbapenem-Resistant Acinetobacter baumannii (CR-Ab), Extended-Spectrum β-Lactamase (ESBL) Klebsiella pneumoniae , and Vancomycin-Resistant Enterococci (VRE). COVID-19 has impacted bacterial HAIs in a number of ways with an increase in the incidence of NDM-CRE and CR-Ab reported at some hospital sites compared to before the pandemic. Recommended guidelines for antimicrobial stewardship in COVID-19 patient treatment are discussed regarding minimisation of empiric broad-spectrum antibiotic use. Other studies have reported a decrease in MRSA and VRE cases that has been attributed to enhanced infection prevention and control (IPC) practices introduced to minimise intra-hospital spread of COVID-19. Implications Poorer outcomes have been observed in hospitalised COVID-19 patients with an antibiotic-resistant infection. While heightened IPC measures have been accompanied by a reduction in some HAIs at specific sites, in other situations, COVID-19 has been associated with an increase in bacterial HAI incidence. Further research is needed to define the cost-benefit relationship of maintaining COVID-19-related IPC protocols beyond the pandemic to reduce the burden of HAIs. In addition, the longer-term impact of high usage of certain broad-spectrum antibiotics during the COVID-19 pandemic requires evaluation.

show abstract

Section: Multi-drug Resistance and Antimicrobial Stewardshipmentioning

confidence: 99%

The interface between COVID-19 and bacterial healthcare-associated infections

O'Toole

2021

Clinical Microbiology and Infection

129

View full text Add to dashboard Cite

show abstract

“…However, the use of antibiotics has exacerbated the emergence of antimicrobial resistance (AMR) in both commensal and pathogenic bacteria 2 . As a result, AMR, as the "silent pandemic", has become a prevalent threat to human health [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Mobilome-driven segregation of the resistome in biological wastewater treatment

Nies¹,

Busi²,

Kunath³

et al. 2021

Preprint

View full text Add to dashboard Cite

Biological wastewater treatment plants (BWWTP) are considered to be hotspots of evolution and subsequent spread of antimicrobial resistance (AMR). Mobile genetic elements (MGEs) promote the mobilization and dissemination of antimicrobial resistance genes (ARGs) and are thereby critical mediators of AMR within the BWWTP microbial community. At present, it is unclear whether specific AMR categories are differentially disseminated via bacteriophages (phages) or plasmids. To understand the segregation of AMR in relation to MGEs, we analyzed meta-omic (metagenomic, metatranscriptomic and metaproteomic) data systematically collected over 1.5 years from a BWWTP. Our results showed a core group of fifteen AMR categories which were found across all timepoints. Some of these AMR categories were disseminated exclusively (bacitracin) or primarily (aminoglycoside, MLS, sulfonamide) via plasmids or phages (fosfomycin and peptide), whereas others were disseminated equally by both MGEs. Subsequent expression- and protein-level analyses further demonstrated that aminoglycoside, bacitracin and sulfonamide resistance genes were expressed more by plasmids, in contrast to fosfomycin and peptide AMR expression by phages, thereby validating our genomic findings. Longitudinal assessment further underlined these findings whereby the log2-fold changes of aminoglycoside, bacitracin and sulfonamide resistance genes were increased in plasmids, while fosfomycin and peptide resistance showed similar trends in phages. In the analyzed communities, the dominant taxon Candidatus Microthrix parvicella was a major contributor to several AMR categories whereby its plasmids primarily mediated aminoglycoside resistance. Importantly, we also found AMR associated with ESKAPEE pathogens within the BWWTP, for which MGEs also contributed differentially to the dissemination of ARGs. Collectively our findings pave the way towards understanding the segmentation of AMR within MGEs, thereby shedding new light on resistome populations and their mediators, essential elements that are of immediate relevance to human health.

show abstract

“…A further challenge identified with the increased use of alcohol-based sanitisers is the apparent development of alcohol-resistance in certain multi-drug resistant bacterial strains, particularly Enterobacteriaceae [6][7][8][9][10] . It was also noted that patients were colonised earlier by multi-drug resistant organisms, including Acinetobacter and Aeromonas -a finding of significant concern in the light of the limited antibiotic choices open to a resource-constrained environment.…”

Section: Descriptive Experiencementioning

confidence: 99%

“…The unit has in the past been able to ensure low resistance rates and good antibiotic stewardship 4,11 . The theoretical mechanism of this resistance is transfer of free DNA particles between hardy bacteria resulting in alcohol resistance [7][8][9][10][11][12] . This horizontal gene transformation induces the enrichment effects of antibiotic resistance genes in resistant bacteria through the uptake of naked DNA and mobile genetic elements such as plasmids, transposons, integrons, gene cassettes, and bacteriophages.…”

Section: Descriptive Experiencementioning

confidence: 99%

Management Issues with Infection Control during Trauma Resuscitation in the Era of COVID-19: South African Experience.

Hardcastle

Hollander

Ganchi

et al. 2021

Bangladesh J Med Sci

View full text Add to dashboard Cite

Background: This invited short report aims to document the management of trauma and nontrauma ICU patients in one quaternary facility in South Africa during the first two waves of the SARS CoV2 (Covid-19) pandemic in Kwa Zulu-Natal. Content: The setting of the trauma service and the changes made to ensure staff and patient safety are detailed. A brief overview of the clinical experience of caring for both trauma and non-trauma cases is provided along with the management of those cases who were found to be Covid-19 positive. The concerning aspect of increased antibiotic resistance development and the potential roles of antiseptic sanitisers is briefly discussed. Conclusion: Trauma care is essential during the infectious pandemic and there is a risk of increased antibiotic resistance. Doing the basics “right” can prevent staff contamination or adverse patient outcomes. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.72-76

show abstract

The silent pandemic: Emergent antibiotic resistances following the global response to SARS-CoV-2

Cited by 131 publications

References 58 publications

The interface between COVID-19 and bacterial healthcare-associated infections

The interface between COVID-19 and bacterial healthcare-associated infections

Mobilome-driven segregation of the resistome in biological wastewater treatment

Management Issues with Infection Control during Trauma Resuscitation in the Era of COVID-19: South African Experience.

Contact Info

Product

Resources

About