Worrying increase in antimicrobial resistance associated with COVID-19

Martínez Mora, Mario Fabián; Martínez Mora, Mario Fabián

doi:10.18004/mem.iics/1812-9528/2021.019.03.03

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Memorias del Instituto de Investigaciones en Ciencias de la Salud

versión On-line ISSN 1812-9528

Mem. Inst. Investig. Cienc. Salud vol.19 no.3 Asunción dic. 2021

https://doi.org/10.18004/mem.iics/1812-9528/2021.019.03.03

Articles

Worrying increase in antimicrobial resistance associated with COVID-19

Mario Fabián Martínez Mora¹
http://orcid.org/0000-0001-7781-9506

^¹Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud. San Lorenzo, Paraguay

The discovery of antimicrobials and their application has been one of the major advances in the history of medicine. However, antimicrobial resistance (AMR) threatens to hamper and even revert some of these advances¹. The emergence and spread of this resistance are growing and complex phenomena, declared as a public health problem, and responsible for countless deaths and high economic costs (2). This silent epidemic is the cause of around 700,000 deaths a year worldwide and it is estimated that, in the absence of effective action, by the year 2050, it will cause more than 10 million deaths annually¹.

In recent years, emerging mechanisms of resistance to various antimicrobials have been detected and reported worldwide, such as colistin in Enterobacterales through the mcr-1 gene³ and the increasing appearance and dissemination of different carbapenemases (mediated enzymes by plasmids and that confer resistance to carbapenems)⁴^-⁶, previously not described, even these bacteria can carry more than one of these enzymes, further complicating this problem⁷^,⁸.

The recent appearance of COVID-19, a disease caused by SARS-CoV-2, has directly contributed to the increase in AMR globally⁹, already caused by other factors, mainly those related to the indiscriminate use of antimicrobials in different sectors. The prognosis and complications experienced by many SARS-CoV-2 infected patients created a massive infodemic¹⁰ that made it difficult to find reliable sources and correct guidance, leading many to use antibiotics as a panacea for the treatment of the infection of this virus (11). Excessive or improper antibiotics prescriptions in the context of the COVID-19 pandemic has facilitated the development of resistant bacteria and further reduced the efficacy of future treatments.

On the other hand, the high prevalence of bacterial superinfections in patients with COVID-19 who require hospitalization, mainly in those with specific comorbidities, complications, prolonged stays and mechanical ventilation, is and continues to be a factor for the overuse of antimicrobials¹². This is how today we face an additional problem: post-covid ADR, due to the overuse of many broad-spectrum antimicrobials related to SARS-CoV-2 infections.

This represents new local and global challenges, which must be approached from different perspectives. It is essential to continue working on the implementation of the Programs for the Optimization of the Use of Antimicrobials (PROA) in hospitals and clinics, and on the knowledge about the multiple microorganisms that can affect health. It is also important to strengthen communication and awareness about the justified and prudent use of antibiotics in the general population, and that it should always be under medical indication.

The COVID-19 pandemic constitutes an unprecedented challenge in all aspects of health care, also in the effective use of antibiotics and the management of bacterial infections. Therefore extreme caution must be exercised in the use of this type of medication in order to mitigate the possible catastrophic scenarios of this silent pandemic associated with antimicrobial resistance.

REFERENCIAS BIBLIOGRÁFICAS

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