A desperate need Saving the lives of Covid patients during the first waves of the pandemic, along with shortages of hospital staff and protective equipment, led to a shocking reversal against the deadly superbug, according to a new analysis from the US Centers for Disease Control and Prevention.
The report, released July 12, synthesizes laboratory data and hospital admissions data to reach a grim conclusion: From 2019 to 2020, the number of antibiotic-resistant infections occurring in hospitals, and the resulting deaths, increased by at least 15 percent. For some of the most difficult-to-treat pathogens, the increase rose 26 percent to 78 percent. And those numbers are even worse than they seem, because in the years immediately preceding the pandemic, resistant infections in hospitals across the U.S. were reduced by nearly a third—meaning that Covid wiped out years of progress in reducing one of the most important health services. obstinate threats to patients.
“The pandemic created the perfect storm for this to happen,” says Arjun Srinivasan, a physician and associate director of the CDC’s Health Care-Associated Infection Prevention Programs. “You had a large number of patients who needed very advanced care, often in intensive care units — who needed central lines, needed urinary catheters, needed mechanical ventilation; all those increasing risks for infection, all those increasing risks for infections with antibiotic-resistant organisms.”
But medical experts say hidden in the frightening trend — and not present in the CDC report — is a surprising bright spot. Some US hospitals have been able to reduce the susceptibility of their patients to superbugs by continuing to support the prevention programs they had in place before the pandemic began, and in particular by preventing the staff of those programs from being diverted to different tasks.
Any use of antibiotics carries the possibility of causing resistance, as bacteria adapt to defend themselves. So hospitals run programs, widely known as antibiotic stewardship, that track which drugs are being used and reserve the most valuable compounds as a last-ditch option. At the same time, they maintain infection prevention teams to protect patients from infections that can occur when medical devices accidentally introduce bacteria into the body, or drug treatments suppress the immune system, or pathogens are transferred between patients on staff gowns or hands.
When masks and protective equipment ran out during the first waves, healthcare workers were unable to replace their equipment as they normally would. In closed wards, they may have skipped safety steps to try to save lives. And while desperately ill patients flooded intensive care units, clinicians put them on antibiotics as a precaution – not to control Covid, because the virus is not affected by those drugs, but to prevent other infections. CDC analysis reveals that in 2020, nearly 80 percent of Covid patients received at least one antibiotic during their hospital stay, a far higher percentage than usual.
Uncomfortable predictions over the past two years have suggested this could happen. In the early months of the pandemic, multiple experts, including the former director of the CDC, issued warnings that the widespread use of antibiotics among the earliest Covid patients lit the fuse on a ticking time bomb. In March 2021, the Pew Charitable Trusts project predicted that resistance rates would certainly rise because so many Covid patients were receiving antibiotics. And by the end of that year, evidence began to arrive that they were right. A CDC analysis last September found that Covid’s pressures on health care have reversed years of progress in reducing infections in already hospitalized people. This May, researchers from pharmaceutical giant Merck and medical technology company Becton Dickinson presented preliminary data showing that rates of resistant infections in 271 US hospitals rose in 2020 and 2021 – in patients with and without Covid – compared to 2019.