Pandemic Prompts CDC to Strengthen Antibiotic Stewardship and Infection Prevention Programs

Finding that the COVID-19 pandemic disrupted best antibiotic practices and efforts to reduce antimicrobial-resistant infections, the Centers for Disease Control and Prevention (CDC) announced plans to strengthen antibiotic stewardship and infection prevention programs against future healthcare disruptions, in their 2022 Special Report, COVID-19 US Impact on Antimicrobial Resistance.

"As the pandemic pushed healthcare facilities, departments and communities near their breaking points in 2020, we saw a significant increase in antimicrobial use, difficulty in following infection prevention and control guidance, and a resulting increase in healthcare-associated, antimicrobial-resistant infections in US Hospitals," Rochelle Walensky, MD, MPH, CDC director, wrote in her forward to the report.

In response, the CDC is exploring investments in the US infrastructure that could help improve the resilience and effectiveness of these systems, including:

• Supporting uninterrupted laboratory supplies and equipment for patient care, infection control, and data tracking during emergencies and surge outbreaks
• Merging strategies to respond to COVID-19 and antimicrobial-resistance such as using telehealth for contact tracing, supporting specimen self-collection, and offering express clinics that allow walk-in testing for sexually transmitted infections
• Expanding use of automated data to the National Healthcare Safety Network (NHSN) to reduce manual data collection and submission for areas such as antibiotic use and antimicrobial resistance

Increased investments are also anticipated in healthcare training and education; with new initiatives, and expansion of programs like the CDC's Project Firstline, which was developed at the start of the pandemic to help meet infection control education needs of the diverse healthcare workforce.

"It is essential to train anyone working in a healthcare on infection prevention and control and to maintain thee practices to protect themselves, their coworkers and their patients," The CDC report states.

Additional investments are expected to extend to state and local health departments, as part of the CDC's CARB (Combating Antibiotic-Resistant Bacteria) National Action Plan. The report also indicates plans for continued/increased funding for antimicrobial resistance (AR) training and testing programs, such as the AR Solutions Initiative and the AR Lab Network, which were also utilized against the pandemic and for SARS-CoV-2 testing.

In the press release announcing the new report, Denise Cardo, MD, director of CDC's Division of Healthcare Quality Promotion, emphasized the importance of expanding on effective prevention strategies already underway.

"The 2021 launch of the Global AR Lab and Response Network and the Global Action in Health Network is an example of how aggressively CDC is moving to combat antimicrobial resistance not only in the US, but in nearly 50 countries across the world.We made significant progress before the pandemic, and I'm confident that we will make significant progress going forward," Cardo said.

Additional measures that are anticipated in the report include:

• Continuing to improve antibiotic and antifungal prescribing and use across healthcare settings, including encouraging use of CDC’s National Healthcare Safety Network (NHSN) antibiotic use module for reporting and implementing CDC’s Core Elements across settings
• Enhancing communication of the latest antibiotic and antifungal use recommendations and guidance to healthcare workers
• Supporting the development of new vaccines to address antimicrobial-resistant pathogens and other conditions for which antibiotics and antifungals are commonly prescribed
• Working with partners to promote optimal antibiotic and antifungal use and appropriate tracking for companion animals and plant agriculture
• Supporting basic and applied research and development for new antibiotics and antifungals, therapeutics, and vaccines.