Increase in Hospital-Acquired Antibiotic-Resistant Infections During the COVID-19 Pandemic

Recent research has highlighted a concerning rise in hospital-onset antimicrobial-resistant (AMR) infections across U.S. hospitals during the COVID-19 pandemic and into the subsequent period. Published online on April 29 in the Annals of Internal Medicine, the study analyzed data from 243 hospitals nationwide and revealed significant increases in antimicrobial resistance rates.

Specifically, the incidence of antimicrobial-resistant infections grew from 182 to 193 per 10,000 hospitalizations at the height of the pandemic, representing a 6.5% rise. More notably, hospital-onset resistant infections surged by approximately 31.5%, moving from 28.9 to 38.0 per 10,000 hospitalizations. Factors such as higher illness severity—necessitating intensive care, mechanical ventilation, and vasopressor support—along with comorbidities and prior antibiotic exposure, were strongly associated with the risk of developing resistant infections. Interestingly, hospital-specific factors appeared less influential.

As the pandemic subsided, rates of AMR infections returned to pre-pandemic levels, but hospital-onset resistant infections remained elevated at 32.3 per 10,000 hospitalizations, still above baseline. The researchers emphasized that antibiotic exposure in the three months prior had a substantial impact on increasing resistance, underscoring the importance of prudent antibiotic use.

These findings suggest that the pandemic period exacerbated the challenge of antimicrobial resistance in healthcare settings. Addressing modifiable factors like antibiotic stewardship could be crucial in mitigating this ongoing crisis.

For more detailed insights, see the original study: Christina Yek et al, Impact of the COVID-19 Pandemic on Antibiotic Resistant Infection Burden in U.S. Hospitals, Annals of Internal Medicine, 2025.