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Review
. 2023 Apr;16(4):611-617.
doi: 10.1016/j.jiph.2023.02.021. Epub 2023 Feb 21.

A parallel and silent emerging pandemic: Antimicrobial resistance (AMR) amid COVID-19 pandemic

Suriya Rehman  1
Affiliations
Review

A parallel and silent emerging pandemic: Antimicrobial resistance (AMR) amid COVID-19 pandemic

Suriya Rehman. J Infect Public Health. 2023 Apr.

Abstract

World is in the middle of the pandemic (COVID-19), caused by SARS-COV-2 virus, which is a significant global health crisis after Spanish influenza in the beginning of 20th century. Progressive drastic steps have been enforced to minimize the transmission of the disease. Likewise, in the current years, antimicrobial resistance (AMR) has been referred as one of the potential perils to the global economy and health; however, it is now veiled under the present pandemic. During the current pandemic, AMR to available frontline antibiotics may prove fatal and life threatening to bacterial and fungal infections during routine procedures like elective surgery, C-sections, etc. Currently, a swift elevation in multidrug-resistant organisms (MDROs), like carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Acinetobacter baumannii, Enterobacterales, extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), multi-triazole-resistant Aspergillus fumigatus and pan-echinocandin-resistant Candida glabrata has been seen. Thereupon, the global outbreak of COVID-19 also offers some important ramification for developing antimicrobial drug resistance. This article aims to highlights episodes and aspects of AMR prevalence, impact of management and mismanagement of COVID-19 crisis, hospital settings, community, environment, and travel on the AMR during the current pandemic.

Keywords: Antimicrobial resistance (AMR); Bacteria; Covid-19; Disinfectants; Fungi; Travel.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
AMR by bacteria is acquired through mutated “resistance genes” via vertical transfer; gene intake from lysed bacteria, that can also occur between different strains; plasmids as carrier of genes as a horizontal transfer between one bacterium to the other and viruses transporting the genes.
Fig. 2
Fig. 2
Antimicrobial resistance in bacterial co-infections. Bacteria can develop the mechanism that avoid the target either by producing enzymes capable of destroying the drug or modifying their structure. Bacteria use efflux pumps to remove the antimicrobial or reduce the affinity by mutating the target.
Fig. 3
Fig. 3
Fungal resistance against antifungal compounds. (A) Fungi likely increase the production of enzymes that are main targets for the drugs. This counters the inhibition of metabolic activities. (B) Modifying the spatial structure of target enzyme minimizes the drug binding efficiency. (C) Efflux pumps efficiently pumps out the antifungal drugs out of the cell. (D) fungal cell wall/membrane blocks the penetration of antifungals. (E) The fungal cell escapes the routine pathway that the drug recognizes to target. (E) The secretion of extracellular enzymes having the ability to degrade the antifungal drug.
Fig. 4
Fig. 4
Incoherent usage of disinfectants leading to proliferation of resistant microbes that would be needing next generation antibiotics.
See this image and copyright information in PMC

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