Global Impact of COVID-19 Pandemic on Antimicrobial Resistance: An Overview

Abstract

Antimicrobial Resistance (AMR) is a condition which occurs, when pathogens evolve and no longer respond to antibiotics, making infections more difficult to treat and leads to death. Apart from the truth that antibiotics have increased the life expectancy of human, AMR is a serious threat. AMR is a major public health threat declared by World Health Organisation (WHO) since 2014. During the different waves of the pandemic, patients with Coronavirus Disease-2019 (COVID-19) infection caused by the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) accounted for the majority of hospital admissions, frequently necessitating an antibiotic upon admission. Among hospitalised patients with COVID-19 infection, a major cause of mortality was mainly due to secondary infections, which was due to overuse of antibiotics and poor infection control procedures which may lead to rapid emergence of Multidrug Resistance (MDR). Before COVID-19 pandemic, AMR was estimated to kill around 700,000 people yearly that are predicted to increase upto 10 million by 2050. Before COVID-19 pandemic, there was lower incidence of hospital associated infections across world. AMR was surprisingly prevalent in patients with bacterial co-infections during the first 18 months of the COVID-19 pandemic. The latest update as per WHO guidance for antibiotic stewardship, which does not recommend antibiotic therapy or prophylaxis for patients with mild/moderate COVID-19 unless signs and symptoms of a bacterial infection. Now, the researchers must consider secondary bacterial infection rate, MDR isolation rate, and high mortality among COVID-19 with secondary infection. This shows the urgent need for surveillance, reinforcement of infection control practices and strict antimicrobial stewardship to combat increasing AMR.