New data from the Centers for Disease Control and Prevention highlights one of the many consequences of the covid-19 pandemic in the United States: a disturbing rise in drug-resistant superbug infections. The first year of the pandemic saw the number of resistant infections and deaths in hospitals once again climb, reversing what had been a promising downward trend. Pandemic-related gaps in data collection have also made it harder to track the spread of superbugs in our communities, such as gonorrhea.
The CDC’s special report is the first by the agency since 2019 to gauge the toll and threat of drug-resistant infections in the country. In 2020, the report found, there was at least a 15% increase from the previous year in both hospital-acquired resistant infections and deaths. But the rise was even higher for certain infections, such as a 78% jump in cases caused by Carbapenem-resistant Acinetobacter. Overall, the rate of new cases rose in four out of six major types of infections. And more than 29,000 Americans died from healthcare-related drug-resistant germs that year, with nearly 40% of these fatal infections caught at a hospital.
Even these numbers are underselling the problem, though, since the CDC was unable to gather reliable data on half of the 18 superbugs that it’s most intently tracking, which are often spreading outside of hospitals and other health-care settings. These infections include Clostridioides difficile (C. diff), Campylobacter, nontyphoidal Salmonella, and gonorrhea, one of the most common STIs in the U.S. Other data has shown that cases of gonorrhea, resistant or not, have been climbing in recent years.
“This report really confirms what earlier studies and data had suggested has been happening during the pandemic. But I think what was especially eye-opening was the magnitude of the increases,” David Hyun, director of The Pew Charitable Trusts’ antibiotic resistance project, told Gizmodo by phone.
The report points to several reasons why we’ve lost ground against these infections, which aren’t limited to the U.S.
Many hospitals have been pushed to the breaking point during the pandemic, for instance, making it harder for health care workers to be careful in prescribing antibiotics only when needed. One clear example of this is that patients with suspected covid-19 have routinely been given antibiotics, despite these drugs only being meant to kill bacteria, not viruses. Hospitals filled with severely ill patients may have also allowed infections that quickly gain resistance to spread further than usual, such as those caused by the yeast Candida auris. People sick at home with these germs may have delayed care out of fear, allowing their infection to worsen and spread to others. And programs dedicated to monitoring resistant infections have had their funding and other resources diverted at times to pandemic-related efforts.
There is hope that these trends have changed for the better since 2020, Hyun said. While the pandemic certainly isn’t over, covid-19 vaccines and treatments have steadily lowered the risk of severe illness and death that it can cause, along with the stress it’s placing on our hospitals. Proposed federal legislation called the PASTEUR Act, which has received some bipartisan support, would allocate added resources to speed up the development of new antibiotics. But Hyun cautions that we need to do even more to rein in these resistant infections, and that merely restoring the pre-pandemic status quo won’t be enough to keep us from sliding into a world where many of these common germs are routinely untreatable.
“The key overarching message here is that we need to build back up the public health and healthcare infrastructure that can help mitigate and address antibiotic-resistant infections again. But I would also add that it’s not nearly sufficient to just build back the system that it once was before the pandemic,” he said. “There have to be some considerations of what the new normal should be, because what this pandemic has shown is that the previous system was not enough to survive these kinds of stresses.”