Outbreaks of serious antibiotic-resistant infections in at least two hospitals appear to be related to shortages of staff and protective gear caused by the COVID-19 pandemic, according to a new report which raises concerns that similar scenarios may occur at hospitals nationwide in the coming weeks, as coronavirus cases continue to surge.
The U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report published this week details problems experienced at two hospitals in New Jersey earlier this year, where clusters of carbapenem-resistant acinetobacter baumannii (CRAB) infections emerged during an early wave of COVID-19 infections.
The so-called “superbug” outbreaks involved infections that pose a particular risk, since they are resistant to known antibiotics and are difficult to treat.
CRAB is an infection commonly contracted during hospital stays, involving a pathogen which can survive for extended periods on dry surfaces, making it easily spread by asymptomatic persons colonized with the bacteria.
Researchers determined that the outbreaks largely stemmed from deviations in infection prevention and control. When prevention and control measures resumed, the cases decreased to pre-pandemic numbers, which typically average anywhere from zero to two per month.
In these particular clusters of cases, 62% of patients were admitted to two intensive care units (ICUs) dedicated to caring for COVID-19 patients.
Rise of Antibiotic Resistant Superbug Infections
Even prior to the COVID-19 pandemic, hospitals nationwide were placing increased attention on preventing the spread of superbugs, which can have devastating consequences, especially among vulnerable patients.
The emergence of antibiotic resistant bacteria has largely been the result of antibiotic overuse and overprescribing by doctors, leading to infections that can no longer be treated with existing medications. A recent study indicated nearly half of all antibiotics given to Medicare patients are unnecessary.
Nearly 1 in 7 cases of antibiotic resistant infections are hospital-acquired, stemming from inadequate prevention measures. In some cases, the infections were linked to contaminated hospital floors.
According to the CDC report, shortages in personnel, personal protective equipment and medical supplies during the coronavirus pandemic led to hospitals changing established infection prevention and control practices. Once shortages were mitigated and the infection prevention practices were implemented again, the infections stopped.
“The occurrence of this cluster underscores the potential for multidrug-resistant organisms to spread during events when standard hospital practices might be disrupted; conventional IPC strategies should be reinstated as soon as capacity and resources allow,” wrote study authors.
While shortages in personnel, medical equipment and personnel protective equipment, such as masks and gowns, are largely out of hospital control during spikes of COVID-19 cases during the pandemic, it highlights the vulnerability of healthcare facilities. A recent study indicated antibiotic resistant infections are rising as a result of the challenges faced during the COVID-19 pandemic.
More than 35,000 people die every year in the U.S. as a result of antibiotic-resistant infections. The increased infections during the pandemic emphasize the need to focus on infection prevention and control practices to help avoid cluster and outbreaks of antibiotic resistant diseases.
Healthcare facilities must focus on surveillance, hand washing, and frequent cleaning of patient rooms to help prevent the spread of these pathogens.