Drug-Resistant Infections in Hospitals Soared During the Pandemic, C.D.C. Says

The spread of drug-resistant infections surged during the coronavirus pandemic, killing nearly 30,000 people in 2020 and upending much of the recent progress made in containing the spread of so-called superbugs, according to an analysis by the Centers for Disease Control and Prevention.

Deaths caused by infections impervious to antibiotics and antifungal medications rose 15 percent during the first year of the pandemic compared to 2019, federal health officials found. Much of the increase was tied to the chaos wrought by the coronavirus as doctors and nurses struggled to treat waves of grievously sick patients whose illness they did not fully understand, before vaccines and treatments were widely available.

About 40 percent of the deaths were among hospitalized patients, with the remainder occurring in nursing homes and other health care settings, the C.D.C. report found. Early on, many frontline hospital workers mistakenly administered antibiotics for viral lung infections that did not respond to such drugs, according to the study. Many of the sickest patients spent weeks or months in intensive care units, increasing the chances for drug-resistant bugs to enter their bodies through intravenous lines, catheters and ventilator tubes.

The death toll is likely much higher, federal health officials said, because the public health labs that normally track drug-resistant infections have been swamped during the pandemic, leading to significant gaps in data for many of the most dangerous pathogens.

The C.D.C. said the outbreaks of drug-resistant infections were likely abetted by a nationwide shortage of face masks, gloves and gowns — the vital armor that protects health workers and helps limit the spread of pathogens as they travel from room to room. Because of staff shortages and overwhelmed wards at many hospitals, infection control specialists were often reassigned to provide basic patient care rather than carry out their usual duties of promoting the appropriate use of antibiotics, hand washing and other safety measures, the report said.

“These setbacks can and must be temporary,” Dr. Rochelle P. Walensky, the director of the C.D.C., said in a statement accompanying the report. “The Covid-19 pandemic has made it clear — prevention is preparedness. We must prepare our public health systems to fight multiple threats simultaneously.”

Federal officials were especially concerned about the increased spread of some of the most dangerous pathogens. They found a 78 percent spike in infections of Acinetobacter, a bacteria that is resistant to the antibiotic carbapenem and that often spreads among intensive care patients, and a 60 percent rise in Candida auris, a deadly fungus that often stalks nursing homes and long-term care facilities.

The analysis highlights what public health experts have long described as a slow-moving pandemic. More than 700,000 people across the world die each year from infections that no longer respond to antimicrobial drugs, and health experts warn that the death toll could climb to 10 million by 2050 without a concerted effort to reduce the overuse of antibiotics and to develop new medications.

Antimicrobial resistance occurs when bacteria and fungi mutate to outsmart the drugs that have been designed to vanquish them. This evolutionary process is inevitable, but the more these medications are given to people and farm animals, the more likely the resistance will occur.

Nearly a third of all antibiotics are mistakenly prescribed, according to the C.D.C., oftentimes for respiratory ailments like colds that are caused by viruses. The problem appears to have grown during the pandemic: Eighty percent of hospitalized Covid patients received antibiotics between March and October 2020, the agency noted.

The C.D.C.’s findings are a marked contrast to previous reports that had charted slow but steady progress in combating the hospital-acquired infections that kill 35,000 Americans a year and sicken 2.8 million. Between 2012 and 2019, drug-resistant infections dropped by 18 percent, according to the agency’s 2019 report, which found that the improvements were tied to greater investment in programs to reduce the inappropriate use of antibiotics at hospitals.

The most recent report confirmed what many health care workers and public health experts had suspected based on anecdotal reports and a handful of previous studies.

“The magnitude of how much worse it’s gotten is really alarming,” said David Hyun, the director of the Antibiotic Resistance Project at the Pew Charitable Trusts, a nongovernmental organization. “It also underscores the urgency that we need to really focus and reinvest in the efforts to address this public health issue.”