Comment The coronavirus pandemic has caused a spike in infections and deaths in US hospitals, reversing years of progress in combating one of the most serious public health challenges in modern medicine, according to a new analysis released Tuesday by the Centers for Disease Control and Prevention. In 2020, the first year of the pandemic, infections and deaths among many serious pathogens increased about 15 percent overall from 2019, the report said. Infections of a particularly dangerous drug-resistant bacteria that causes blood and urinary tract infections soared by 78 percent in a year. The report analyzed antimicrobial resistance in the United States, focusing specifically on hospital-acquired superbug infections. Public health efforts had reduced these resistant infections in hospitals by nearly 30 percent between 2012 and 2017. But in 2020, the pandemic pushed hospitals, health departments and communities “close to their breaking point,” CDC Director Rochelle Walensky wrote in the report. Sicker patients overwhelmed the hospitals. They needed more frequent and longer use of medical devices, such as catheters and ventilators. Devices that break the body’s natural protective barrier – the skin – increase the risk of infection. Clinicians unfamiliar with the new disease covid-19 have relied heavily on antibiotics as the first choice for treating patients with fever and shortness of breath – symptoms of the viral illness. From March 2020 to October 2020, nearly 80 percent of patients hospitalized with covid-19 received an antibiotic, the report said. These life-saving drugs work against bacteria, not viruses. High levels of antibiotic prescribing can put patients at risk for side effects and allow drug resistance to develop and spread. In addition, hospitals faced severe shortages of staff and personal protective equipment, especially the higher-quality N95 masks that offer the best protection. In some places, hospital staff used parts they bought from Home Depot and craft stores to create protective face shields for workers. Shocked staff struggled to follow infection prevention and control protocols, the report said. Many staff members were pulled from infection control to help care for covid-19 patients. This created a kind of double whammy: fewer staff to prevent infections, treating more patients at risk for them. “In addition to the devastating impact on the millions of people infected with the coronavirus and the millions of people who have died from the coronavirus, the coronavirus pandemic has had a profound and far-reaching impact on patient safety in the United States,” said Arjun Srinivasan. . , the top CDC official leading the agency’s prevention efforts to control superbugs. “One of the dangerous consequences of Covid … is with these antibiotic-resistant infections, infections that are very difficult to treat, in some cases untreatable, with very high mortality rates.” Some patients recovered from their illness with Covid-19, he said, only to face “a horrible outcome”: dying of a drug-resistant infection. In 2020, more than 29,400 people died from antimicrobial-resistant infections commonly associated with health care, according to the report. Of those, nearly 40 percent acquired the infection while hospitalized. The remaining infections occurred outside the hospital, including nursing homes and others community health care facilities. Because of limited data, the CDC doesn’t know how many people who died from superbug infections also had covid-19. The CDC estimates more than 2.8 million antimicrobial-resistant infections in the United States each year, with more than 35,000 people dying as a result. The total number of deaths in 2020 from these resistant infections may be much higher. surveillance and data reporting were limited due to the pandemic. Antimicrobial resistance occurs because bacteria constantly evolve to repel the drugs used to kill them. As they mutate, some bacteria develop the ability to fight different antibiotics, multiplying and spreading resistance along the way. The more antibiotics are used in healthcare and agriculture, the less effective they become. Antibiotic resistance is especially deadly for patients in hospitals and nursing homes, as well as for those with weakened immune systems. But these hard-to-treat infections are now threatening people undergoing common modern surgeries and treatments, such as knee replacements, organ transplants and cancer treatments. Young and otherwise healthy people can get methicillin-resistant Staphylococcus disease, or MRSA, infection on their skin. Women can get a UTI from another bad germ, ESBL-producing enterobacteriaceae, which can no longer be treated with first-line oral medications and require intravenous antibiotics. Hospital-acquired infections increased in the first year of the pandemic for three of the five resistant bacteria and fungi that pose the greatest threats to human health. The biggest jump was in carbapenem-resistant Acinetobacter, bacteria that cause pneumonia and wounds, blood and urinary tract infections, often in patients in intensive care units. In 2020, nosocomial infections for carbapenem-resistant Acinetobacter increased by 78%, with 7,500 cases and 700 deaths, according to the report. There was also a 60 percent increase in hospital-acquired infections from a deadly superbug yeast called White ear and a 35 percent increase in hospital-acquired infections from carbapenem-resistant enterobacteriaceae (CRE), also known as “nightmare bacteria.” CRE is a large group of bacteria of major concern for patients who require catheters and other devices, long courses of certain antibiotics, or long-term hospitalization. Superbugs are resistant to all or nearly all antibiotics, kill up to half of patients with bloodstream infections, and can transfer their antibiotic resistance to other related bacteria, potentially rendering the other bacteria untreatable. The CDC previously categorized the toll taken by 18 human pathogens, ranking the threat of each as “urgent,” “severe” or “concerning.” However, the agency lacks data on nine of those germs, including many that are spread outside hospital settings. They include drug-resistant and drug-resistant sexually transmitted gonorrhea Streptococcus pneumoniaeleading cause of bacterial pneumonia and meningitis. Of the approximately 6,000 US hospitals, approximately 2,400 voluntarily submit monthly data on antibiotic use to CDC, Srinivasan said. Of these, approximately 1,100 also provide data on persistent errors. “We don’t have the data because our surveillance systems weren’t able to work to give us that information during the pandemic,” Srinivasan said. “This should be as much of a concern for humans as for the pathogens that came up. It’s just as worrying when you don’t know.”
