Hospital-related infections resistant to carbapenems, considered the antibiotics of last resort for treating severe infections, remain at least 35% higher than before the pandemic.
Findings also reveal that during the pandemic, hospitals experiencing surges due to high volumes of severely ill COVID-19 patients had the greatest increases in hospital-acquired antimicrobial-resistant infections, as did larger hospitals with increased bed capacity.
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Despite progress in combating antimicrobial resistance (AMR) in the USA since its peak during the COVID-19 pandemic, hospital-acquired AMR infections remain well above pre-pandemic levels, according to a major new study examining AMR before, during, and after the COVID-19 pandemic in 120 US hospitals.
The study was led by Dr Christina Yek from the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and is being presented at this year's ESCMID Global Congress (formerly ECCMID) in Barcelona, Spain (27-30 April). It reveals that AMR rates remain high largely due to the persistence of hospital-onset infections, in particular those caused by gram-negative resistant organisms.
These findings highlight the urgent need for action to identify the drivers of, and solutions for, difficult-to-treat gram-negative AMR.
AMR is estimated to cause at least 35,000 deaths annually in the US and 1.27 million worldwide [1]. In 2022, a US Centers for Disease Control and Prevention report described alarming rises in AMR across US hospitals during the first year of the COVID-19 pandemic, with resistant hospital-related infections growing 15% between 2019 and 2020 [1]. However, the key drivers and lasting effects of this phenomenon remain unexplored.
To provide an updated report on the status of AMR in US hospitals, researchers analysed trends in incidence of AMR infections in adults (aged 18 years and older) in 120 hospitals before (Jan 2018–Dec 2019), during (March 2020–Feb 2022), and after the pandemic (March–Dec 2022), that were continuously reporting in the PINC-AI database—an administrative dataset representing 20% of US hospitalisations.
All hospitalisations were examined for culture-confirmed infection by six pathogens—methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum cephalosporin-resistant Enterobacterales (ECR), and carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CR-PA)—acquired either before (community-acquired) or after three days of hospitalisation.
