Did COVID show us what AMR could become?

Please read the original article at: https://doi.org/10.1038/s41467-024-49122-2

Disclaimer: Below is an interpretation of the article thus do not necessarily represent the views of the authors.

Did COVID show us what AMR could become?

The spread of AMR has been described as a silent pandemic, affecting millions worldwide though without the level of attention COVID captured. But that's not what I mean.

The pandemic offered a rare glimpse into how rigorous interventions competed against inundated healthcare systems. With more vulnerable patients and overstretched staff, you might expect systems to be overwhelmed and multidrug-resistant (MDR) bacteria to run rampant.

However, these researchers found the opposite.

Set in the tertiary care hospital QEHB, they saw lower prevalence of MDR bacteria, rarer colonisations of high-risk strains, and little evidence of bacterial transmission between Intensive Care Unit (ICU) patients compared to similar studies. It seems the interventions overcame the challenges COVID posed.

Of course, it's not realistic to keep humanity in a sterile box to defeat AMR. But what this study shows is what AMR in hospital ICUs could become with maximal interventions in place. This offers hope that with practical alternatives, we can achieve similar results.

That said, this optimism must be tempered by certain limitations of the study. Pathogenic bacteria account for a tiny proportion of the gut microbiome, although generally more prevalent within ICU patients. Therefore, straightforward culturing without enrichment may miss these rarer pathogenic strains. Metagenomics, unfortunately, does not sufficiently address this issue.

The study was also conducted when public COVID-19 restrictions were being eased in England, prior to the emergence of the Omicron variant. The article doesn't specify how QEHB adapted its protocols during the pandemic or whether changes were made during this period. A brief description of these unique protocols would provide valuable context.

Nonetheless, the findings are a promising reminder of what’s achievable. By implementing the strongest interventions, the hospital was able to control AMR, even in the face of unprecedented challenges. This study offers hope that with practical, scalable alternatives, similar successes in AMR control are within reach.