Antimicrobial Resistance in the COVID era: A New Potential Crisis?

By Shreya Ramesh 

The beginning of the pandemic was certainly crazy, to say the least. Obsessively buying hand sanitizer, disinfectant wipes, and even toilet paper led to an extreme shortage of such items in stores for months to come. Buying these items certainly may have provided some sense of safety and security, but this feeling may be short-lived; the overuse of cleaning products may lead to a future, and potentially deadly, antimicrobial resistance (AMR) crisis. 

According to the World Health Organization (WHO), antimicrobial resistance occurs when bacteria, fungi, viruses, and other microbes mutate and evolve in ways rendering medicine and cleaning products ineffective. As a result, these evolved microbes can cause serious infections and increase the risk of spreading deadly diseases. The potential for antimicrobial resistance outbreaks in hospitals has increased significantly since the start of the pandemic. The WHO has noted that hospitals, in an attempt to maintain sanitary conditions and prevent the spread of COVID-19, increased their antimicrobial use to combat the risk of hospital-contracted infections and multidrug-resistant organism transmission (Getahun et al.) Sometimes, these antimicrobial products are unnecessarily used. The research seems to support this claim: according to one study, nearly 72% of COVID-19 patients received unnecessary antibiotics,which may accelerate the AMR problem drastically (Strathdee et al.). As a result of this overuse, some COVID-19 patients contracted AMR fungal infections, which have the potential to lead to serious complications in patients with weak immune systems, such as severe diarrhea and even infertility. AMR infections may even emerge in some households because some cleaning products contain the chemical compound triclosan, a compound that some researchers indicate could contribute to antimicrobial resistance (Aiello et al.).

In the not-so-distant future, AMR may present unknown, and even deadly risks for humanity. AMR could force us back into a battle between us and powerful microbes, a costly and very deadly battle. But, most importantly, it is a battle that is preventable and solvable with the right tools!

Solving the issue of AMR is two-fold: developing the proper infrastructure to kill off microbes and creating tools to prevent this issue from compounding over time. A recent study on COVID-19’s impact on AMR noted that despite outbreaks of AMR in Germany, Italy, and the United States, certain hospitals in France and Spain did not report an increase in such infections, likely due to differences in infection prevention and control practices. Implementing such practices in hospitals everywhere may have the potential to reduce AMR. Additionally, the WHO finds that educating the public and health workers treating COVID-19 patients against overusing cleaning agents is imperative. As a result, the WHO has created various programs to teach professionals about AMR and has also established the World Antibiotic Awareness Week to promote open communication with the public about this risk. 

In order to solve the AMR crisis, scientists have already begun experimenting with bacteriophages and CRISPR. Through the use of CRISPR technology, scientists are developing ways to engineer bacteriophages, a type of simple viruses, to target and destroy specific bacteria. Although this research is not yet commercially available, phages may be able to be used to treat bacterial infections in the future.

Unfortunately, the impact of the COVID-19 pandemic on AMR will only become clear in the coming months and years as data gradually become available. However, there are measures we can take every day to prevent the situation from potentially escalating (Monnet and Harbath). People often do not know how much cleaning product they should use, so the CDC has established some basic guidelines for people to follow. Among the top tips are cleaning high-touch surfaces daily, cleaning other surfaces with safe products when they are visibly dirty, ensuring that disinfectants are used in places with good ventilation, and washing hands with normal soap and water for at least twenty seconds after going outside. As long as we follow the instructions on the label of these cleaning products and these guidelines, we can keep ourselves and others safe!

One of the biggest lessons we must learn is understanding how to balance safety and overuse. Once we collectively understand this valuable lesson, we can effectively prevent a potential public health crisis while remaining safe and healthy.

References

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Centers for Disease Control and Prevention. (2021, March 2). Biggest Threats and Data. Centers for Disease Control and Prevention. https://www.cdc.gov/drugresistance/biggest-threats.html. 

Centers for Disease Control and Prevention. (2021, April 5). COVID-19 and Your Health. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/disinfecting-your-home.html

Getahun, H., Smith, I., Trivedi, K., Paulin, S., & Balkhy, H. H. (2020). Tackling antimicrobial resistance in the COVID-19 pandemic. Bulletin of the World Health Organization, 98(7), 442-442A. https://doi.org/10.2471/blt.20.268573

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Monnet, D. L., & Harbarth, S. (2020, November 12). Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance? Eurosurveillance. 25(45), 2001886. https://doi.org/10.2807/1560-7917.ES.2020.25.45.2001886

Strathdee, S. A., Davies, S. C., & Marcelin, J. R. (2020). Confronting antimicrobial resistance beyond the COVID-19 pandemic and the 2020 US election. The Lancet, 396(10257), 1050–1053. https://doi.org/10.1016/s0140-6736(20)32063-8

World Health Organization. (2016, October 7). Awareness and education. https://www.who.int/antimicrobial-resistance/global-action-plan/awareness/en/

World Health Organization. (2020, October 13). Antimicrobial resistance.  https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance#:~:text=What%20is%20antimicrobial%20resistance%3F,spread%2C%20severe%20illness%20and%20death

World Health Organization. (2020, November 18). Preventing the COVID-19 pandemic from causing an antibiotic resistance catastrophe. https://www.euro.who.int/en/health-topics/disease -prevention/antimicrobial-resistance/news/news/2020/11/preventing-the-covid-19-pandemic-from-causing-an-antibiotic-resistance-catastrophe