Increased antimicrobial resistance during the COVID-19 pandemic

Chih-Cheng Lai; Shey-Ying Chen; Wen-Chien Ko; Po-Ren Hsueh

doi:10.1016/j.ijantimicag.2021.106324

Increased antimicrobial resistance during the COVID-19 pandemic

Int J Antimicrob Agents. 2021 Apr;57(4):106324. doi: 10.1016/j.ijantimicag.2021.106324. Epub 2021 Mar 19.

Authors

Chih-Cheng Lai¹, Shey-Ying Chen², Wen-Chien Ko³, Po-Ren Hsueh⁴

Affiliations

¹ Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.
² Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Center for Quality Management, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁴ Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.

Abstract

In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. There has been a rapid increase in multidrug-resistant organisms (MDROs), including extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA), pan-echinocandin-resistant Candida glabrata and multi-triazole-resistant Aspergillus fumigatus. The cause is multifactorial and is particularly related to high rates of antimicrobial agent utilisation in COVID-19 patients with a relatively low rate of co- or secondary infection. Appropriate prescription and optimised use of antimicrobials according to the principles of antimicrobial stewardship as well as quality diagnosis and aggressive infection control measures may help prevent the occurrence of MDROs during this pandemic.

Keywords: Antibiotic usage; Antimicrobial resistance; COVID-19; Multidrug-resistant organism.

Publication types

Review

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use*
Antimicrobial Stewardship
Bacteria / drug effects
Bacterial Infections / complications*
Bacterial Infections / drug therapy
Bacterial Infections / epidemiology
COVID-19 / complications*
COVID-19 / epidemiology*
Coinfection / drug therapy*
Coinfection / epidemiology
Drug Resistance, Microbial*
Drug Utilization
Fungi / drug effects
Humans
Incidence
Mycoses / complications*
Mycoses / drug therapy
Mycoses / epidemiology
Pandemics

Substances

Anti-Bacterial Agents