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The coronavirus pandemic caused an increase in superbacterial infections and deaths in U.S. hospitals, reversing years of progress in fighting 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 several serious pathogens increased by about 15 percent overall since 2019, according to the report. Infections of an especially dangerous drug-resistant bacterium that causes infections of the bloodstream and urinary tract shot up 78 percent in one year.
The report analyzed antimicrobial resistance in the United States, focusing specifically on superbacterial infections that began in hospitals.
Public health efforts had reduced these hospital-resistant infections by nearly 30 percent between 2012 and 2017. But in 2020, the pandemic pushed hospitals, health departments and communities “close to their breaking points,” CDC director Rochelle Walensky wrote in the report.
The sickest 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.
Doctors unfamiliar with the new covid-19 disease relied heavily on antibiotics as the first choice to treat patients with fever and shortness of breath, symptoms of viral disease. From March 2020 to October 2020, nearly 80 percent of patients hospitalized with covid-19 received an antibiotic, according to the report. These life-saving drugs work against bacteria, not viruses. High levels of antibiotic prescription can put patients at risk for side effects and allow the development and spread of drug resistance.
In addition, hospitals faced a severe shortage of personnel and personal protective equipment, especially the higher quality N95 masks that offer the best protection. In some places, hospital staff used pieces purchased at Home Depot and craft stores to create face shields for workers. Overwhelmed staff had difficulty following infection prevention and control protocols, according to the report. Many staff members turned away from infection control to help care for patients with covid-19. This created a kind of double mess: fewer staff members to prevent infections by treating more patients at risk for them.
“In addition to having devastating impacts on the millions of people who had covid and the millions who died of covid, the covid pandemic 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 side effects of covid … is with these antibiotic-resistant infections, infections that are very difficult to treat, in some cases intractable, with very high mortality rates.”
Some patients recovered from their covid-19 disease, he said, only to face “a horrible result”: dying from 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 these, nearly 40 percent acquired the infection while hospitalized. The rest of the infections occurred outside the hospital, including nursing homes and others community health facilities. Due to limited data, the CDC does not know how many people who died from superbacterial infections also had covid-19.
The CDC estimates that there are more than 2.8 million antimicrobial-resistant infections in the United States each year, with the deaths of more than 35,000 people as a result. The total number of deaths in 2020 from these resistant infections may be much higher; surveillance and data reporting were reduced due to the pandemic.
Antimicrobial resistance occurs because bacteria are constantly evolving to defend themselves from 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 used in health care and agriculture, the less effective they become.
Antibiotic resistance is particularly deadly for patients in hospitals and nursing homes, and for those with weak immune systems. But these difficult-to-treat infections now threaten people undergoing common modern surgeries and therapies, such as knee replacements, organ transplants, and cancer treatments.
Young and healthy people can get a methicillin resistant Staphylococcus aureus, or MRSA, an infection on your skin. Women can get a urinary tract infection from another bad insect, ESBL-producing enterobacteria, which can no longer be treated with first-line oral medications and require intravenous antibiotics.
Hospital 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, bloodstream, and urinary tract infections, often among patients in intensive care units. In 2020, hospital infections for resistant carbapenems Acinetobacter it rose 78 percent, with 7,500 cases and 700 deaths, according to the report.
There was also a 60 percent increase in hospital infections of a deadly superbacterial yeast called White ear and a 35 percent increase in hospital-acquired carbapenem-resistant enterobacteriaceae (CRE) infections, also known as “nightmare bacteria”. CREs are a large group of bacteria of great concern to patients who require catheters and other devices, long courses of some antibiotics, or long hospital stays. Superbacteria are resistant to all or almost all antibiotics, kill up to half of patients who contract bloodstream infections, and can transfer their antibiotic resistance to other related bacteria, making other bacteria untreatable.
The CDC had previously categorized the toll that 18 pathogens are catching on humans, classifying the threat of each as “urgent,” “serious,” or “worrying.” But the agency is missing data again from these germs, including many that are out of the hospital. They include sexually transmitted drug-resistant gonorrhea and drug-resistant gonorrhea Streptococcus pneumoniaeone of the leading causes of bacterial pneumonia and meningitis.
Of the approximately 6,000 U.S. hospitals, about 2,400 voluntarily submit monthly data on antibiotic use to the CDC, Srinivasan said; of these, about 1,100 also provide data on resistant errors.
“We don’t have the data because our surveillance systems couldn’t even function to provide us with this information during the pandemic,” Srinivasan said. “That should be as alarming to people as the pathogens they increased. It’s just as alarming when you don’t know it.”