Antibiotic Resistance Surges in US Hospitals During and After COVID-19

A retrospective study has revealed a concerning surge in antibiotic resistance (AMR) within U.S. hospitals, notably during and even after the COVID-19 pandemic. This rise poses a significant threat to patient health, necessitating urgent action to counter the increasing prevalence of resistant bacteria.

Pandemic’s Impact on Antibiotic Resistance

In 2022, the Centers for Disease Control and Prevention (CDC) found a minimum 15% upswing in issues tied to antimicrobial resistance in US hospitals during the initial year of the COVID-19 outbreak. The increase in AMR has had repercussions for patients regardless of COVID status and all hospital environments as well as nearby populations. This occurred alongside widespread antibiotic usage.

The study scrutinized data from 243 hospitals, covering nearly 10 million hospitalizations from January 2018 to December 2022. The research evaluated the pre-pandemic (January 2018 to December 2019), pandemic peak (March 2020 to February 2022), and post-pandemic (March to December 2022) periods. The investigation tracked the rates of various resistant germs, including MRSA, VRE, and specific gram-negative bacteria.

“During the COVVI-19 pandemic, AMR infections increased from 182 to 193 for 10,000 hospitalizations, an increase of 6.5 %.”

—Study Researcher

The research indicated that infections contracted within the hospital environment saw the highest increase, reaching 31.6% compared to 0.8% in the community. Sepsis showed the most frequent rise, up 21.5%, succeeded by respiratory infections (+9.4%) and urinary infections (+8.7%).

A recent report indicates that over 35,000 people in the US die each year from antibiotic-resistant infections (CDC, 2024), highlighting the critical nature of the situation.

Post-Pandemic Trends

After the pandemic, community infections showed a tendency to revert to their baseline incidence. However, hospital-based infections remained elevated, exceeding their basic value by 11.6%. During the pandemic, infections with AMR climbed by 45.7% for Acinetobacter-R, 19.4% for carbapenem-resistant enterobacteria, 11.4% for pyocyanic-R, and 6% for vancomycin-resistant enterococci.

Factors potentially associated with AMR in hospital patients included age over 77, male sex, the severity of illness, prior antibiotic exposure, and admission to intensive care. COVID patients displayed a slightly greater propensity to contract an intra-hospital AMR infection.

Contributing Factors and Future Outlook

The study suggests that the rise in antibiotic resistance was influenced by host-related elements, illness severity, and antibiotic use within three months prior. The prescription of beta-lactams and third-generation cephalosporins may have also contributed to the emergence of gram-negative resistant bacteria, rather than MRSA.

The investigation’s strengths included the considerable data collected, encompassing nearly 25% of U.S. hospitals. Moving forward, new methods to combat antibiotic resistance, particularly against gram-negative resistant germs, are essential. Emergency plans must be established to halt the decline in progress made in the fight against antibiotics during recent years.