Increased antimicrobial resistance during the COVID-19 pandemic

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

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