CDC: Resistant hospital infections increased 20% during COVID-19 pandemic
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Key takeaways:
- Antimicrobial-resistant hospital infections caused by seven pathogens increased a combined 20%.
- The number of reported clinical cases of Candida auris increased fivefold from 2019 to 2022.
There was a combined 20% increase in six antimicrobial-resistant hospital infections in the United States during the COVID-19 pandemic, and the number of clinical cases of Candida auris increased fivefold, according to the CDC.
“The increases in antimicrobial resistance [AMR] burden seen in 2020 and 2021 are likely due in part to the impact of COVID-19, which pushed health care facilities, health departments and communities near their breaking points,” the CDC said in a fact sheet published Tuesday.
“As the pandemic continued, health care providers and public health professionals took aggressive action to prevent infections and protect lives, helping to reduce the burden from its 2021 peak,” the agency said.
The CDC has published periodic reports on AMR threats in the U.S. The 2019 report found that resistant organisms caused one death every 15 minutes. Researchers also have reported increased resistant infections both in the U.S. and globally since the beginning of the COVID-19 pandemic.
In 2020, the CDC included AMR burden for seven antimicrobial-resistant pathogens typically found in health care settings in its COVID-19 Impact Report, reporting that rates or cases increased roughly 15% from 2019 during the first year of the pandemic.
The new report compared data from 2020, 2021 and 2022 with data from the 2019 report on:
- carbapenem-resistant Enterobacterales (CRE);
- carbapenem-resistant Acinetobacter;
- C . auris;
- MRSA;
- vancomycin-resistant Enterococcus (VRE);
- extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales; and
- multidrug-resistant (MDR) Pseudomonas aeruginosa.
According to the CDC, six of the seven pathogens either increased in rate or number of infections from 2019 to 2022, with only hospital-onset MRSA remaining stable. Among the pathogens, hospital-onset MRSA is the only one that decreased during the 4-year period, from 2021 to 2022.
“These data and the threat that antimicrobial-resistant infections pose underscore a continued need to sustain investments in CDC programs that advance prevention strategies,” Thomas R. Talbot, III, MD, MPH, FSHEA, president of the Society for Healthcare Epidemiology of America board of trustees, said in a statement.
Earlier in July, the House Appropriations Committee approved legislation to cut funding for the departments of Labor, Health and Human Services, and Education by 11% for 2025, which includes cuts to the NIH, Hospital Preparedness Program, Health Resources and Services Administration, and other federal health care agencies, including the CDC, according to the American Hospital Association.
In the statement, Talbot said that a proposed 20% cut in funding for the CDC, elimination of the Agency for Healthcare Research and Quality, and “radically restructuring” of the NIH would make it harder to combat the increasing threat posed by AMR.
“Sufficient funding for effecting infection monitoring practices, accurate laboratory detection and rapid response are critical to limiting harmful resistant infections,” he said.
The CDC said it plans to release estimates for the burden of at least 19 AMR threats in 2025 and in the future will release new AMR threat estimates every 2 years.
References:
- CDC. Antimicrobial resistance: Antimicrobial resistance threats in the United States, 2021-2022. https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html. Published July 16, 2024. Accessed July 16, 2024.
- House committee passes HHS appropriations bill for FY 2025. https://www.aha.org/news/headline/2024-07-10-house-committee-passes-hhs-appropriations-bill-fy-2025. Published July 10, 2024. Accessed July 16, 2024.
- SHEA urges investment given rise of antimicrobial resistance during COVID-19 pandemic. https://shea-online.org/shea-urges-investment-given-rise-of-antimicrobial-resistance-during-covid-19-pandemic/. Published July 16, 2024. Accessed July 16, 2024.
Perspective
Back to TopAnurag N. Malani, MD
In general, resistant organisms and resistant infections are almost always more difficult to treat, and there are also fewer antimicrobials available in that sort of landscape, so they’re inherently more difficult to treat.
One of the organisms the CDC cited is Candida auris. In southeastern Michigan, this is absolutely something that we are seeing much more now than what we saw pre-pandemic. It’s much more significant now. Before, it was very uncommon to hear about — maybe a case or a culture that showed Candida auris. But now, it’s probably every few weeks I’m hearing about cases in patients who are either colonized or infected.
I think what CDC reported is also what we’re seeing clinically at the local level. It is important because these infections are inherently more difficult to treat, and outcomes related to patients who have these types of infections — when you compare them to nonresistant infections — are going to be worse.
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CDC. Antimicrobial resistance threats in the United States, 2021-2022. https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html. Published July 16, 2024. Accessed July 16, 2024.
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