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Cited by 174Antibiotic Use and ResistanceInfection Control in HealthcareCOVID-19 and healthcare impacts

Impact of the COVID-19 pandemic on the surveillance, prevention and control of antimicrobial resistance: a global survey

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Tomczyk, Sara, Taylor, Angelina, Brown, Allison, de Kraker, Marlieke E A, El-Saed, Aiman, Alshamrani, Majid, Hendriksen, Rene S, Jacob, Megan +10 more·2021·Journal of Antimicrobial Chemotherapy
DOI 10.1093/jac/dkab300PMC PMC8499888

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Abstract

OBJECTIVES: The COVID-19 pandemic has had a substantial impact on health systems. The WHO Antimicrobial Resistance (AMR) Surveillance and Quality Assessment Collaborating Centres Network conducted a survey to assess the effects of COVID-19 on AMR surveillance, prevention and control. METHODS: From October to December 2020, WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) national focal points completed a questionnaire, including Likert scales and open-ended questions. Data were descriptively analysed, income/regional differences were assessed and free-text questions were thematically analysed. RESULTS: Seventy-three countries across income levels participated. During the COVID-19 pandemic, 67% reported limited ability to work with AMR partnerships; decreases in funding were frequently reported by low- and middle-income countries (LMICs; P < 0.01). Reduced availability of nursing, medical and public health staff for AMR was reported by 71%, 69% and 64%, respectively, whereas 67% reported stable cleaning staff availability. The majority (58%) reported reduced reagents/consumables, particularly LMICs (P < 0.01). Decreased numbers of cultures, elective procedures, chronically ill admissions and outpatients and increased ICU admissions reported could bias AMR data. Reported overall infection prevention and control (IPC) improvement could decrease AMR rates, whereas increases in selected inappropriate IPC practices and antimicrobial prescribing could increase rates. Most did not yet have complete data on changing AMR rates due to COVID-19. CONCLUSIONS: This was the first survey to explore the global impact of COVID-19 on AMR among GLASS countries. Responses highlight important actions to help ensure that AMR remains a global health priority, including engaging with GLASS to facilitate reliable AMR surveillance data, seizing the opportunity to develop more sustainable IPC programmes, promoting integrated antibiotic stewardship guidance, leveraging increased laboratory capabilities and other system-strengthening efforts.

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  • The reduction in the number of microbiological cultures, elective procedures, and outpatient visits, alongside an increase in ICU admissions and admissions of chronically ill patients, could skew and subsequently bias AMR data used in the study.

    “The reduction in the number of microbiological cultures, elective procedures, and outpatient visits, alongside an increase in ICU admissions and admissions of chronically ill patients, could skew and subsequently bias AMR data used in our study.65, 75”

    From Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 (2024) · cites this paper as [65]

    The Discussion (AMR surveillance) says fewer cultures, elective surgeries and outpatient visits, together with more ICU admissions, could bias AMR data. But it reports a decrease—not an increase—in admissions of chronically ill patients, as the Results (Patient-case mix) also confirms. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • The use of personal protective equipment, enhanced hand hygiene, and physical distancing, together with a greater number of focal points of infection prevention and control in LMICs, are salient factors that likely contributed to the temporary decrease in the transmission of resistant microorganisms while these measures were in effect.

    “The use of personal protective equipment, enhanced hand hygiene, and physical distancing (together with a greater number of focal points of infection prevention and control in LMICs) are salient factors that likely contributed to the temporary decrease in the transmission of resistant microorganisms while these measures were in effect.65”

    From Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 (2024) · cites this paper as [65]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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Research works printed but not linked: 25

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Authors
Tomczyk, S., Taylor, A., Brown, A., de Kraker, M. E. A., El-Saed, A., Alshamrani, M., Hendriksen, R. S., Jacob, M., Löfmark, S., Perovic, O., Shetty, N., Sievert, D., Smith, R., Stelling, J., Thakur, S., Vietor, A. C., Eckmanns, T., & the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network
Affiliations
  • Robert Koch Institute (DE)
  • Centers for Disease Control and Prevention (US)
  • Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety, Geneva, Switzerland
  • King Abdulaziz Medical City, WHO Collaborating Centre for Infection Prevention and Control and Anti-Microbial, Riyadh, Saudi Arabia
  • King Abdulaziz Medical City (SA)
  • North Carolina State University (US)
  • Public Health Agency of Sweden (SE)
  • University of the Witwatersrand (ZA)
  • Brigham and Women's Hospital (US)
Corresponding author
Tomczyk, Sara
ORCID
Venue
Journal of Antimicrobial Chemotherapy
Publisher
Oxford University Press (OUP)
Published
2021-09-02
Volume
76
Issue
11
Pages
3045-3058
ISSN
  • 0305-7453 (ISSN-L)
  • 1460-2091
DOI
10.1093/jac/dkab300
PMC
PMC8499888
OpenAlex
W3197379249
Cited by
174
References
0
Citations by year
2026: 17 · 2025: 44 · 2024: 26 · 2023: 39 · 2022: 43 · 2021: 5
FWCI
16.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Antimicrobial Chemotherapy (publishedVersion, cc-by-nc)
  • medRxiv (acceptedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Publication server of the Robert Koch Institute (Robert Kock Institute) (submittedVersion, cc-by-nc)
  • Technical University of Denmark, DTU Orbit (Technical University of Denmark, DTU) (submittedVersion, cc-by-nc)
Funders
  • WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) team
  • WHO Collaborating Centres
  • the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network
  • WHO AMR Surveillance and Quality Assessment Collaborating Centres Network
  • the Network at the Robert Koch Institute in Berlin, Germany
  • the Global Protection Programme
  • German Federal Ministry of Health
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
Keywords
COVID-19 pandemic, antimicrobial resistance, antimicrobial resistance surveillance, infection control, antibiotic stewardship, glass, low- and middle-income countries, health system disruption, antimicrobial prescribing, laboratory capacity
MeSH terms
COVID-19, SARS-CoV-2, Anti-Infective Agents, Anti-Bacterial Agents, Humans, Surveys and Questionnaires, Drug Resistance, Bacterial, Pandemics

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