Antimicrobial resistance: A challenge awaiting the post COVID-19 era

Lobie, Tekle Airgecho; Roba, Akililu Abraham; Booth, James Alexander; Kristiansen, Knut Ivan; Aseffa, Abraham; Skarstad, Kirsten; Bjørås, Magnar

Microbe exposure to pharmaceutical and non-pharmaceutical agents plays a role in the development of antibiotic resistance. The risks and consequences associated with extensive disinfectant use during the COVID-19 pandemic remain unclear. Some disinfectants, like sanitizers, contain genotoxic chemicals that damage microbial DNA, like phenol and hydrogen peroxide. This damage activates error-prone DNA repair enzymes, which can lead to mutations that induce antimicrobial resistance. Public health priority programs that have faced drug-resistance challenges associated with diseases, such as tuberculosis, HIV, and malaria, have given less attention to risks attributable to the COVID-19 pandemic. Pathogen-specific programs, like the directly observed treatment strategy, which were designed to fight resistance against anti-tuberculosis drugs, have currently become impractical, because COVID-19 restrictions have limited in-person visits to health institutions. Here, we summarized the key findings of studies on the current state of antimicrobial resistance development, from the perspective of current disinfectant use. Additionally, we provided a brief overview of the consequences of restricted access to health services, due to COVID-19 precautions, and their implications on drug resistance development.