Antimicrobial-resistant hospital infections remain above pre-pandemic levels

May 2, 2024
Major US study findings.

A new report published by EurekAlert, describes the status of antimicrobial resistance in US hospitals and found that during the COVID-19 pandemic, hospital-acquired antimicrobial-resistant infections increased by 32%, and they still remain at least 12% above pre-pandemic levels.

The study was led by Dr. Christina Yek from the US National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH).

According to the release, the researchers analyzed trends in incidence of AMR infections in adults (aged 18 years and older) in 120 hospitals before (Jan 2018–Dec 2019), during (March 2020–Feb 2022), and after the pandemic (March–Dec 2022), that were continuously reporting in the PINC-AI database—an administrative dataset representing 20% of US hospitalizations.

All hospitalizations were examined for culture-confirmed infection by six pathogens—methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum cephalosporin-resistant Enterobacterales (ECR), and carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CR-PA)—acquired either before (community-acquired) or after three days of hospitalization.

During the pandemic, the overall prevalence of AMR infections increased by 6.3% (from 181.9 to 193.3 per 10,000 hospitalizations. This was driven primarily by a steep rise in hospital-acquired resistant infections, which rose at least 32% (from 28.7 to 38.0 per 10,000 hospitalizations), compared with community-acquired infections, which increased just 1.4% (153.2 to 155.3 per 10,000 hospitalizations), according to EurekAlert.

During the pandemic, infections due to gram-negative pathogens increased by almost 20% compared to pre-pandemic levels, while resistant gram-positive infections fell by 4.2%.

EurekAlert said the greatest increases were seen in hospital-acquired infections resistant to commonly prescribed antibiotics called carbapenems. These included infections caused by CRAB which grew 151% during the two years of the pandemic (0.5 to 1.3 per 10,000 hospitalizations), followed by CRE which rose 62% (1.1 to 1.8 per 10,000 hospitalizations), and CR-PA which increased by 54% (2.2 to 3.4 per 10,000 hospitalizations).

During and after the pandemic, community-acquired MRSA infections declined by 10% (from 71.1 to 63.7 per 10,000 hospitalizations) and 19% (71.1 to 57.8 per 10,000 hospitalizations), respectively.

The researchers also found that hospitals with the highest levels of surges in severely ill COVID-19 patients during the pandemic had the largest increases in hospital-acquired AMR infections. Larger hospitals with the highest bed capacity (500 beds) had more than double the odds of AMR infections compared to hospitals with the lowest bed capacity (0-99 beds).

EurekAlert has the full release