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. 2021 Feb 16:10:e64139.
doi: 10.7554/eLife.64139.

Antimicrobial resistance and COVID-19: Intersections and implications

Gwenan M Knight  1   2   3   4 , Rebecca E Glover  1   5 , C Finn McQuaid  1   2   3   4 , Ioana D Olaru  1   6   7 , Karin Gallandat  1   8 , Quentin J Leclerc  1   2   3 , Naomi M Fuller  1   2   3 , Sam J Willcocks  1   9 , Rumina Hasan  1   10   11 , Esther van Kleef  12 , Clare Ir Chandler  1   13
Affiliations

Antimicrobial resistance and COVID-19: Intersections and implications

Gwenan M Knight et al. Elife. .

Abstract

Before the coronavirus 2019 (COVID-19) pandemic began, antimicrobial resistance (AMR) was among the top priorities for global public health. Already a complex challenge, AMR now needs to be addressed in a changing healthcare landscape. Here, we analyse how changes due to COVID-19 in terms of antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term. However, the opposite effects may be seen if antibiotics are more widely used as standard healthcare pathways break down. Over 6 months into the COVID-19 pandemic, the dynamics of AMR remain uncertain. We call for the AMR community to keep a global perspective while designing finely tuned surveillance and research to continue to improve our preparedness and response to these intersecting public health challenges.

Keywords: COVID-19; antimicrobial resistance; epidemiology; global health.

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Conflict of interest statement

GK, RG, CM, IO, KG, QL, NF, SW, RH, Ev, CC No competing interests declared

Figures

Figure 1.
Figure 1.. A grid of examples of the interactions between the dimensions of change brought on by the coronavirus disease 2019 (COVID-19) pandemic (rows) and the key components in the evolution of antimicrobial resistance (AMR, columns).
This is not exhaustive but highlights the variability across the intersection and can be used to support the identification of research priorities. For more information, see the related dimension of change section in the text. ARO: antimicrobial-resistant organism; PPE: personal protective equipment.
See this image and copyright information in PMC

References

    1. Abena PM, Decloedt EH, Bottieau E, Suleman F, Adejumo P, Sam-Agudu NA, Muyembe TamFum JJ, Seydi M, Eholie SP, Mills EJ, Kallay O, Zumla A, Nachega JB. Chloroquine and hydroxychloroquine for the prevention or treatment of COVID-19 in africa: caution for inappropriate Off-label use in healthcare settings. The American Journal of Tropical Medicine and Hygiene. 2020;102:1184–1188. doi: 10.4269/ajtmh.20-0290. - DOI - PMC - PubMed
    1. Access to Medicine Foundation Shortages, stockouts and scarcity: the issues facing the security of antibiotic supply and the role for pharmaceutical companies [White paper. [May 31, 2018];2018 https://accesstomedicinefoundation.org/publications/shortages-stockouts-...
    1. Acosta AM, Mathis AL, Budnitz DS, Geller AI, Chai SJ, Alden NB, Meek J, Anderson EJ, Ryan P, Kim S, Como-Sabetti K, Torres S, Dufort E, Bennett NM, Billing LM, Sutton M, Keipp Talbot H, George A, Pham H, Hall AJ, Fry A, Garg S, Kim L. COVID-19 investigational treatments in use among hospitalized patients identified through the US coronavirus disease 2019-Associated hospitalization surveillance network, March 1-June 30, 2020. Open Forum Infectious Diseases. 2020;7:ofaa528. doi: 10.1093/ofid/ofaa528. - DOI - PMC - PubMed
    1. Adepoju P. Tuberculosis and HIV responses threatened by COVID-19. The Lancet HIV. 2020;7:e319–e320. doi: 10.1016/S2352-3018(20)30109-0. - DOI - PMC - PubMed
    1. Ahmed F, Ahmed N, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. The Lancet Public Health. 2020;5:e240. doi: 10.1016/S2468-2667(20)30085-2. - DOI - PMC - PubMed

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