Pandemic led to surge in antibiotic-resistant 'superbugs,' CDC says

The COVID-19 pandemic caused a surge in antibiotic-resistant "superbug" infections in hospitals, pushing back years of progress made combating antimicrobial resistance, according to a new analysis released Tuesday by the Centers for Disease Control and Prevention (CDC).

The threat of antimicrobial-resistant infections is not only still present but has gotten worse, according to the analysis. Hospital-onset deaths and infections from antimicrobial resistant bacteria both increased at least 15 percent in 2020 compared to 2019, the report found. 

The analysis highlighted seven different pathogens, including a 78 percent increase in a type of bacteria that can cause infections of the blood, urinary tract, lungs and wounds.

The U.S. health system has made a concerted effort to reduce deaths from antimicrobial-resistant infection. Dedicated infection prevention and control efforts dropped those infections 18 percent overall and by nearly 30 percent in hospitals between 2012 and 2017, the report said.

But the pandemic has undone much of the progress as it pushed health care facilities, health departments and communities "near their breaking points in 2020," CDC Director Rochelle Walensky wrote in the report.

In 2020, "we saw a significant increase in antimicrobial use, difficulty in following infection prevention and control guidance, and a resulting increase in healthcare-associated, antimicrobial-resistant infections in U.S. hospitals," Walensky wrote.

The inpatient population in 2020 was very different from the pre-pandemic population — hospitals saw higher numbers of sicker patients who needed an extended length of stay, which increased their risk for resistant infections. 

The patients also required more frequent and longer use of catheters and ventilators, which  increased the risk of infections and spread of pathogens," especially when combined with personal protective equipment and lab supply challenges, reduced staff, and longer lengths of stay," the report stated.

The pandemic also greatly impacted antibiotic prescribing, the report found.When a patient receives an antibiotic they do not need, not only does the patient get no benefit, but they are also put at risk for side effects.

From March 2020 to October 2020, almost 80 percent of patients hospitalized with COVID-19 received an antibiotic. ​​Antibiotics were the first option given to people who showed up at hospitals with a fever and shortness of breath — symptoms of a viral illness of COVID-19, not bacteria.

In 2020, more than 29,400 people died of antimicrobial-resistant infections commonly associated with health care, the report found. Of these, nearly 40 percent acquired the infection while hospitalized. Yet the total national burden of deaths from antibiotic resistant bacteria may be much higher, since data gaps caused by the pandemic hinder the analysis.