Impact of SARS-CoV-2 Epidemic on Antimicrobial Resistance: A Literature Review

Abstract

Antimicrobial resistance is an urgent threat to public health and global development; in this scenario, the SARS-CoV2 pandemic has caused a major disruption of healthcare systems and practices. A narrative review was conducted on articles focusing on the impact of COVID-19 on multidrug-resistant gram-negative, gram-positive bacteria, and fungi. We found that, worldwide, multiple studies reported an unexpected high incidence of infections due to methicillin-resistant S. aureus, carbapenem-resistant A. baumannii, carbapenem-resistant Enterobacteriaceae, and C. auris among COVID-19 patients admitted to the intensive care unit. In this setting, inappropriate antimicrobial exposure, environmental contamination, and discontinuation of infection control measures may have driven selection and diffusion of drug-resistant pathogens.

Cefiderocol for Severe Carbapenem-Resistant A. baumannii Pneumonia: Towards the Comprehension of Its Place in Therapy

“…Among them, carbapenem-resistant A. baumannii (CRAB) poses a particular risk, being classified as an “urgent threat” by the Centers of Disease Control and Prevention [ 5 ] due to its extremely limited treatment options [ 6 ] and its capacity to survive on healthcare facility surfaces and shared medical equipment [ 7 ]. Furthermore, healthcare disruption due to the COVID-19 pandemic, especially within intensive care units (ICUs), may have led to an increase in CRAB nosocomial outbreaks [ 8 ]. In particular, a recent metanalysis [ 9 ] showed that nearly half of critically ill COVID-19 patients admitted into the ICU develop ventilator-associated pneumonia, with mortality rates as high as 42%.…”

An Evidence-Based Multidisciplinary Approach Focused on Creating Algorithms for Targeted Therapy of Infection-Related Ventilator-Associated Complications (IVACs) Caused by Pseudomonas aeruginosa and Acinetobacter baumannii in Critically Ill Adult Patients

“…Finally, it should be mentioned that the current COVID-19 pandemic has led to a worldwide rise in antimicrobial resistance due to the massive disruption of infection control and antimicrobial stewardship measures in COVID ICUs. This caused a remarkable proportion of MDR bacterial co-infections and super-infections (including Pseudomonas aeruginosa and Acinetobacter baumannii ) in severe COVID-19 patients [ 105 ]. In this scenario of more and more growing antimicrobial resistance, educational programs for improving the culture of knowledge of appropriate antibiotic use and the pivotal role of antimicrobial stewardship should be planned and delivered to young physicians [ 106 ].…”

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“…The recent appearance of COVID-19, a disease caused by SARS-CoV-2, has directly contributed to the increase in AMR globally (9) , already caused by other factors, mainly those related to the indiscriminate use of antimicrobials. in different sectors.…”

“…La reciente aparición del COVID-19, enfermedad causada por el SARS-CoV-2, ha contribuido en forma directa al incremento de la RAM a nivel global (9) , ya ocasionada por otros factores, principalmente aquellos relacionados al uso indiscriminado de los antimicrobianos en diferentes sectores. El pronóstico y las complicaciones que tenían muchos pacientes infectados por SARS-CoV-2 creó una infodemia masiva (10) que dificultó el hallazgo de fuentes confiables y orientación correcta, llevando a muchos a utilizar antibióticos como una panacea para el tratamiento de la infección por este virus (11) .…”