Antibiotic-resistant infections up in US hospitals during COVID, data show
Patients hospitalized during the COVID-19 pandemic and tested for SARS-CoV-2 had higher rates of antibiotic-resistant infections compared with those hospitalized before the pandemic, according to a study presented yesterday at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2022).
The multicenter retrospective cohort study by scientists with Merck and Becton, Dickinson and Company looked at data on adults admitted to 271 US hospitals before (July 2019 through February 2020) and during (March 2020 through October 2021) the COVID-19 pandemic. All admissions with an antimicrobial resistance (AMR) event, defined as a non-contaminated first positive culture for select gram-positive or gram-negative pathogens with non-susceptibility, were reported. AMR rates were further evaluated based on community-onset (CO) and hospital-onset (HO) infections.
Overall, there were 1,789,458 patients admitted in the pre-pandemic period and 3,729,208 admitted during the pandemic. The AMR rate was 3.54 per 1,000 admissions pre-pandemic and 3.47/1,000 admissions during the pandemic. But among patients who tested both positive and negative for SARS-CoV-2 during the pandemic, the AMR rate was 4.92/1,000 and 4.11/1,000, respectively. For HO infections, the AMR rate was 0.77/1,000 pre-pandemic and 0.86/1,000 during the pandemic—2.19/1,000 for those tested positive for SARS-CoV-2 and 1.00/1,000 for those who tested negative.
For CO infections, the AMR rate was 2.76/1,000 and 2.61/1,000 in the pre-pandemic and pandemic periods, respectively.
"These new data highlight the importance of closely monitoring the impact of COVID-19 on antimicrobial resistance rates," study co-author Karri Bauer, PharmD, said in an ECCMID press release. "It is particularly worrying that antibiotic resistance has been rising during the pandemic in both SARS-CoV-2 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before."
Danish study suggests potential C difficile spread between pigs, humans
A study conducted in Danish pigs found strains of Clostridioides difficile that were similar to those found in humans, with multiple resistance genes, researchers reported late last week at ECCMID.
In the study, researchers from the University of Copenhagen and Statens Serum Institut tested 514 samples collected in two batches from 14 Danish pig farms for the presence of C difficile. They also conducted whole-genome sequencing to determine the multilocus sequence type, toxins, and resistance genes, and to compare the pig isolates to isolates collected from human C difficile patients during the same period.
A total 54 pig samples from the two batches tested positive, with further analysis showing that C difficile was more common in piglets and sows than in slaughter pigs. All isolates were toxigenic, and 13 sequence types were found, all of which were also present in the human samples. The most prevalent sequence type in the pig and human isolates was ST11, and in 16 cases, the ST11 isolates in the pigs were nearly identical to the human isolates, a finding that suggests the potential for transfer between pigs and humans.
Thirty-eight isolates from pigs contained at least one resistance gene, and resistance was predicted for at least seven antibiotic classes, the most common being macrolides, beta-lactams, aminoglycosides, and vancomycin.
The study authors say deeper phylogenetic analysis would be needed to determine whether C difficile is spreading from pigs to humans or if transmission is bidirectional. But the identification of shared resistance genes is a concern, they say.
"Our finding of multiple and shared resistance genes indicate that C. difficile is a reservoir of antimicrobial resistance genes that can be exchanged between animals and humans," study co-author Semeh Bejaoui, PhD, said in an ECCMID press release. "This alarming discovery suggests that resistance to antibiotics can spread more widely than previously thought, and confirms links in the resistance chain leading from farm animals to humans."
Apr 23 ECCMID abstract
Apr 23 ECCMID poster
Apr 23 ECCMID press release
Johnson & Johnson launches drug-development center in South Africa
Pharmaceutical company Johnson & Johnson (J&J) today announced the launch of a new satellite center in South Africa that will focus on developing drugs to combat AMR.
According to a company press release, the J&J Satellite Center for Global Health Discovery at the Holistic Drug Discovery and Development (H3D) Centre at the University of Cape Town will bolster early-stage research and development with a focus on multidrug-resistant gram-negative bacteria, are is a threat in Africa and around the world. J&J officials say the center aims to boost Africa's scientific capacity as a global hub for discovery research, and will be part of a larger, global scientific network that will help stimulate local innovation.
"Investing to increase the capacity of the innovation ecosystem in Africa is critical to strengthening the R&D pipeline for entrenched and emerging global health challenges," said Ruxandra Draghia-Akli, MD, PhD, Global Head, Global Public Health R&D at Janssen Research & Development, LLC.
"By leveraging the unique strengths of H3D and the J&J Centers, we can cultivate the talent and capacity needed to drive innovation in the global fight against AMR."
Apr 25 J&J press release