HHS Report Clarifies Factors That Led to High Levels of Antimicrobial Resistance During COVID Pandemic

A new report from HHS “suggests that a number of interrelated factors hampered the ability of US hospitals to control antimicrobial resistance (AMR) during the COVID-19 pandemic.” CIDRAP has the news.

The report, which comes from HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE), lays out several reasons behind the “15% increases in drug-resistant hospital-acquired infections (HAIs) and AMR-related deaths in the first year of the pandemic compared with pre-pandemic levels.”

The factors are all “connected to the crush of severely ill patients that descended on hospitals across the country when the COVID-19 pandemic hit in early 2020. According to the report, an estimated 3.6 million COVID-19–related hospitalizations occurred in the United States from May 2020 to April 2021, occupying up to 90% of all available inpatient beds in some hospitals.” Those patients were hospitalized for over 14 days on average and many underwent mechanical ventilation.

Since few treatments were available, “an estimated 80% of hospitalized US COVID-19 patients received antibiotics from March to October 2020, which likely contributed to rising AMR rates.” Plus, exhausted healthcare workers “had to focus on immediate patient care and their own needs, making it difficult to sustain the infection prevention and control (IPC) efforts and ASPs that can keep AMR in check.” A 2021 study from CDC “cited the pandemic's strain on hospital staff as one of the reasons for significant increases in central line–associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated events in 2020.”

The authors of this report stress that among the lessons U.S. hospitals should learn from the COVID-19 pandemic include “the importance of timely access to AMR-related data, guidance, and diagnostics; robust communication channels and relationships; and strong ASP leadership and institutional support for healthcare workers.”