CDC Officer: Epidemic “explosion” of antibiotic resistance not seen

The CDC official told Axios that despite the concern over the antimicrobial resistance that was flourishing during the epidemic, as doctors use all their tools to help patients fight COVID-19.

Why it matters: AMR is an increasing problem, as the misuse or overuse of antibiotics creates resistant pathogens, which cause more than 2.8 million infections and more than 35,000 deaths in the US.

What is happening: CDC Associate Director of Healthcare Associated Infection Prevention Program Arjun Srinivasan says that COVID-19 presents a “perfect storm” for AMR infections due to hospital long-term (average 8.4 days), congestion, PPE deficiency and infiltration treatment. is. .

  • “People are prescribing antibiotics because they are worried that the patient may have a bacterial superinfection [sometimes] These are actually signs and symptoms of COVID, ”Amy Mathers, Associate Professor at the University of Virginia’s School of Medicine, tells Axios.
  • “[W]I do not know what is the nature of the disease and we are taking precautions [with a] Like oversubscription of antibiotics, ”says Mathers, who is also the clinical director of the Adult Antimicrobial Stewardship Program at UV Medical Center.
  • Some recent studies have indicated that the proportion of COVID-19 patients who end up with a bacterial co-infection is low, with some saying that regular use of antibiotics is not recommended.

threat level: An analysis found that 72% of patients with COVID-19 received antibiotics, requiring only 8%, meaning “the likelihood of an increase in AMR after this epidemic is real,” Admiral Brett P, assistant secretary of health . Giroir told in a meeting. This week of a Presidential Advisory Council for AMR.

  • But, new initial data found While antibiotic use remains overall – and is a matter of concern – it has fallen from its abatement in March and April and has not yet resulted in any substantial increase in most AMR infections.

“We were all very concerned that we would see this explosion in antibiotic resistance. … So, I think we were pleasantly surprised to see that when there were clearly patients with COVID who had developed resistant infections, we Didn’t see them. The overwhelming numbers that I think many feared. “

– Arjun Srinivasan

Newest: Srinivasan presented some of the initial data of the CDC to the Presidential Advisory Council. Initial antibiotic use findings include more than 1,100 hospitals with more than 2 million discharges …

  • There is no clear evidence that COVID-19 patients are more likely to have bacterial and fungal infections than patients with influenza-like diseases (ILI) such as flu and pneumonia. They were comparing ILI patients from patients of COVID-19 from January to June 2020 from January to March 2019.
  • The number of COVID-19 patients with positive cultures of highly resistant organisms was not much higher than in ILI patients last year, but “sporadic outbreaks” and a greater number of hospital-acquired infections were reported.
  • One exception was found to be more ESBL, an enzyme produced by bacteria that can break down antibiotics, in COVID-19 patients – this was 43% higher than in ILI patients last year. “Does this represent the growing presence of ESBL [overall] … Or some unique susceptibility to ESBLs in patients with COVID is unknown, ”says Srinivasan.
  • But the greatest AMR concern among all hospitalized patients – MRSA – was 7% lower in COVID-19 patients than in patients with ILI last year.

big picture: Srinivasan states that “it is critically important to continue to focus on developing the antibiotic development pipeline” because “even though we use them to the fullest, they become less effective over time . ”

What to see: The FDA will host a meeting next month to present a five-year strategic plan for the National Antimicrobial Resistance Surveillance System (NAMS).

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