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The impact of COVID-19 on the fight against AMR

Published on 16/08/22 at 10:16am

How the responses to the COVID-19 pandemic have affected antibiotic-resistant bacteria

 

Responses to the COVID-19 pandemic may have impacted the epidemiology of antibiotic-resistant bacteria, a new mathematical model has shown.

 

In the research published on bioRxiv, a mathematical model was used to explore how behavioural responses to the COVID-19 pandemic may have impacted antimicrobial resistance (AMR) across communities.

 

AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to drug treatments, making infections harder to treat and increasing the risk of severe illness and death.

 

As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat, with the World Health Organization citing AMR as one of the top ten threats to global health.

 

The ongoing COVID-19 pandemic has coincided with global efforts to combat AMR, and pandemic responses implemented to slow SARS-CoV-2 transmission have dramatically affected the incidence of common viral and bacterial respiratory infections, the study noted.

 

Six varying pandemic scenarios were examined in the study over 90 days, and simulations were used to assess the effect of each scenario on the bacterial carriage prevalence, antibiotic resistance rate and the invasive bacterial disease (IBD) incidence, using parameters based on the commensal community bacterium Streptococcus pneumoniae (S pneumoniae).

 

It was observed that lockdown ‘substantially reduces’ the number of annual cases of resistant IBD (over 70%), although the proportion of resistant bacteria among carriers is expected to increase when prophylactic antibiotics are prescribed in response to SARS-CoV-2 infection.

 

It was also found that a population-wide surge in antibiotic prescribing in the absence of lockdown may contribute to a ‘large increase’ (6%) in the number of IBD cases caused by antibiotic-resistant bacteria, while the effect of reduced antibiotic use is negligible.

 

The study noted that an important limitation of the model is the lack of age structure, as SARS-CoV-2 infection risk, IBD risk, disease severity, bacterial carriage prevalence and antibiotic prescribing are all very different in different age groups.

 

Additionally, while the model used in this study was built and parameterised around S pneumoniae, other bacterial species may have been impacted differently by the COVID-19 outbreak.

 

Nonetheless, according to the study, the findings suggest that COVID-19 pandemic responses ‘may significantly impact antibiotic resistance in the community’, underscoring the need for monitoring resistance during pandemic waves.

Emily Kimber

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