A recent report from the CDC highlights how the COVID-19 pandemic has heightened antimicrobial resistance, resulting in a 20% increase in hospital-onset infections caused by key resistant pathogens.
Threat level for each pathogen, as categorized in CDC’s Antibiotic Resistance Threats in the United States, 2019.
Image credits: CDC
The rise in antimicrobial resistance (AR) burden during 2020 and 2021 is closely associated with the COVID-19 pandemic. The pandemic strained healthcare systems, leading to longer hospital stays, disrupted infection control practices, and increased inappropriate antibiotic use. Consequently, AR peaked in 2021 but began to decline following aggressive public health interventions.
On July 16, 2024, the CDC published new data detailing the burden of seven key antimicrobial-resistant pathogens in healthcare settings. This report highlights a significant increase in infections during the pandemic, particularly affecting the following pathogens:
Comparative data reveal that hospital-onset infections from six bacterial pathogens rose by 20% during the pandemic, with rates remaining elevated in 2022. Notably, cases of C auris surged nearly five-fold from 2019 to 2022.
According to the CDC, “AR happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow. Resistant infections can be difficult, and sometimes impossible, to treat.”
As of December 2023, 97 products in clinical development targeting drug-resistant infections caused by WHO-identified priority pathogens. This includes 57 antibiotics and 40 non-traditional antibacterials. Three products have advanced to the pre-registration phase, signaling potential market availability.3
Yukiko Nakatani, PhD, WHO’s assistant director-general for AR, emphasized the urgency of the situation: “Antimicrobial resistance is only getting worse, yet we’re not developing new trailblazing products fast enough to combat the most dangerous and deadly bacteria.” She pointed out the challenges in innovation and access to new antibacterial agents across different income levels.3
A recent study on Staphylococcus aureus resistance trends in the US revealed a significant decline in methicillin-resistant MRSA prevalence among outpatient infections, decreasing from 53.6% in 2010 to 38.8% in 2019. Although, there was a concerning rise in resistance to tetracyclines and trimethoprim-sulfamethoxazole (TMP-SMX) among MRSA and methicillin-sensitive S aureus (MSSA) strains. MRSA resistance to tetracycline increased from 3.6% to 12.8%.4
The study highlighted that the highest MRSA rates were found in the South, likely influenced by sociodemographic and climate factors. Utilizing data from Veterans Health Administration clinics, the findings underscore the importance of localized surveillance to inform treatment strategies and encourage clinicians to stay informed about local resistance patterns.4
In response to the AR crisis, the CDC has utilized American Rescue Plan Act funding to support health departments in various initiatives, including:
Additionally, the CDC’s Antimicrobial Resistance Laboratory Network analyzed over 230,000 patient samples to enhance detection and containment efforts.
Despite recent improvements, ongoing investment in effective public health strategies remains crucial to combat AR. Starting in 2025, the CDC plans to release updated estimates on at least 19 AR threats in a new electronic format, facilitating more informed policymaking and resource allocation. This marks a significant advancement in the monitoring and management of AR in the US. The CDC’s plans to update data on antimicrobial resistance threats will support informed policy decisions and resource allocation.
