Post-Coronavirus Disease 2019 Pandemic Antimicrobial Resistance
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Updated: Jun 29, 2025
Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Lucia Boccabella1, Elena Gialluca Palma2, Ludovico Abenavoli3
1Internal Medicine Unit, Madonna del Soccorso General Hospital, Via Luciano Manara 7, 63074 San Benedetto del Tronto, Italy.
Background And Aim:
Antimicrobial resistance (AMR) is a chronic issue of our Westernized society, mainly because of the uncontrolled and improper use of antimicrobials. The coronavirus disease 2019 (COVID-19) pandemic has triggered and expanded AMR diffusion all over the world, and its clinical and therapeutic features have changed. Thus, we aimed to review evidence from the literature on the definition and causative agents of AMR in the frame of the COVID-19 post-pandemic era.
Methods:
We conducted a search on PubMed and Medline for original articles, reviews, meta-analyses, and case series using the following keywords, their acronyms, and their associations: antibiotics, antimicrobial resistance, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), COVID-19 pandemic, personal protective equipment.
Results:
AMR had a significant rise in incidence both in in-hospital and outpatient populations (ranging from 5 up to 50%) worldwide, but with a variegated profile according to the germ and microorganism considered. Not only bacteria but also fungi have developed more frequent and diffuse AMR. These findings are explained by the increased use and misuse of antibiotics and preventive measures during the first waves of the SARS-CoV2 pandemic, especially in hospitalized patients. Subsequently, the reduction in and end of the lockdown and the use of personal protective equipment have allowed for the indiscriminate circulation of resistant microorganisms from low-income countries to the rest of the world with the emergence of new multi- and polyresistant organisms. However, there is not a clear association between COVID-19 and AMR changes in the post-pandemic period.
Conclusions:
AMR in some microorganisms has significantly increased and changed its characteristics during and after the end of the pandemic phase of COVID-19. An integrated supranational monitoring approach to this challenge is warranted in the years to come. In detail, a rational, personalized, and regulated use of antibiotics and antimicrobials is needed.
Insights
Antimicrobial resistance (AMR) significantly increased globally during and after the COVID-19 pandemic, affecting both bacteria and fungi. A coordinated global approach and rational antimicrobial use are crucial to combat this growing public health threat.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) is a persistent global health challenge exacerbated by the COVID-19 pandemic.
- The pandemic led to increased antimicrobial use and altered transmission dynamics, impacting AMR patterns.
Purpose of the Study:
- To review and synthesize evidence on the definition and causative agents of AMR in the post-COVID-19 era.
- To understand the impact of the pandemic on the evolution and characteristics of antimicrobial resistance.
Main Methods:
- A comprehensive literature search was performed on PubMed and Medline.
- Keywords included "antibiotics," "antimicrobial resistance," "SARS-CoV2," "COVID-19 pandemic," and "personal protective equipment."
- Included original articles, reviews, meta-analyses, and case series.
Main Results:
- AMR incidence rose significantly (5-50%) globally in both hospital and outpatient settings, affecting bacteria and fungi.
- Increased antibiotic use during the pandemic and global travel post-lockdown facilitated the spread of resistant organisms.
- No clear direct association was found between COVID-19 infection itself and AMR changes in the post-pandemic period.
Conclusions:
- AMR has significantly increased and evolved during and after the COVID-19 pandemic.
- An integrated, supranational monitoring system is essential for managing AMR.
- Rational, personalized, and regulated use of antimicrobials is imperative.
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