Murray, Democrats Urge CDC to Combat Antimicrobial Resistant Infections Associated With COVID-19

Democrats urge CDC Director Redfield to address the threat of antimicrobial resistant infections compounding the public health threat posed by COVID-19

There are nearly three million antimicrobial resistant infections in the United States each year

Murray, Democrats: “It is critical you act to make sure the threat of antimicrobial resistance doesn’t complicate the already unprecedented challenge of the COVID-19 pandemic and leave even more patients with an infection our tools can’t effectively help fight.”

(Washington, D.C.) – Today, U.S. Senator Patty Murray (D-WA), Ranking Member of the Senate Committee on Health, Education, Labor, and Pensions (HELP) and six of her fellow Senate Democrats wrote to Centers for Disease Control and Prevention (CDC) Director Robert Redfield about the threat of antimicrobial resistant infections associated with COVID-19. The Senators expressed concern about how antimicrobial resistance could complicate the COVID-19 crisis, and urged the CDC to use funds allocated under the CARES Act to expand surveillance of bacterial co-infections associated with COVID-19 and to assist State and local health authorities in reporting antimicrobial resistance.

“We write to urge you to take swift action to combat antimicrobial resistant infections associated with COVID-19 and to reinforce the importance of robust antibiotic stewardship practices in health care facilities and outpatient settings affected by the COVID-19 outbreak.  The threat of antimicrobial resistance grows more and more concerning as existing antibiotics become less effective due to improper or incomplete courses of treatment and overuse—each year, there are nearly three million antimicrobial resistant infections in the United States. It is critical you act to make sure the threat of antimicrobial resistance doesn’t complicate the already unprecedented challenge of the COVID-19 pandemic and leave even more patients with an infection our tools can’t effectively help fight.” wrote the Senators.

Viral respiratory infections—such as COVID-19—increase the chances a patient will contract bacterial co-infections and hospital settings increase the risk of antimicrobial resistant infection, which can make a patient’s condition more severe and deadly.  One study found that 50 percent of deceased COVID-19 patients experienced a secondary infection. Although preliminary information suggests that antibiotic prescribing is widespread among health professionals treating COVID-19 patients, the CDC does not have comprehensive data on these practices and their impact on antimicrobial resistance. 

The letter was also signed by Senators Dick Durbin (D-IL), Kirsten Gillibrand (D-NY), Elizabeth Warren (D-MA), Sherrod Brown (D-OH), Bob Casey Jr. (D-PA), and Ron Wyden (D-OR).

Read the full letter HERE and below.

July 1, 2020

Robert R. Redfield, MD, Director

U.S. Centers for Disease Control and Prevention (CDC)

1600 Clifton Road

Atlanta, GA  30329

Dear Director Redfield:

We write to urge you to take swift action to combat antimicrobial resistant infections associated with COVID-19 and to reinforce the importance of robust antibiotic stewardship practices in health care facilities and outpatient settings affected by the COVID-19 outbreak.  The threat of antimicrobial resistance grows more and more concerning as existing antibiotics become less effective due to improper or incomplete courses of treatment and overuse—each year, there are nearly three million antimicrobial resistant infections in the United States.^[1]  It is critical you act to make sure the threat of antimicrobial resistance doesn’t complicate the already unprecedented challenge of the COVID-19 pandemic and leave even more patients with an infection our tools can’t effectively help fight.  

Antimicrobial resistance threatens to compound the public health threat posed by COVID-19. Viral respiratory infections predispose patients to bacterial co-infections, which can lead to increased disease severity and mortality. There is early evidence of secondary bacterial infections among COVID-19 patients.^[2] Furthermore, the risk of contracting an antimicrobial resistant infection is higher in hospital settings.^[3] Studies evaluating the significance of bacterial and fungal infections are ongoing, but serious viral respiratory infections carry additional risks associated with secondary infections that can increase mortality and morbidity when patients need to be hospitalized or placed on a ventilator. A recent cohort study that assessed 191 COVID-19 patients found that 50 percent of deceased patients experienced a secondary infection.^[4] 

Preliminary and anecdotal information suggests that antibiotic prescribing is widespread among health professionals treating COVID-19 patients, and CDC does not have comprehensive data on these utilization practices and their impacts on antimicrobial resistance. In response to the threat of secondary bacterial and fungal infections among COVID-19 patients, Congress recently took action through passage of the CARES Act to allocate $1.5 billion in flexible funding to support CDC’s comprehensive response to the COVID-19 coronavirus outbreak.  We encourage CDC to use these funds to (1) quickly expand laboratory and epidemiological surveillance of bacterial co-infections associated with COVID-19 infection, and (2) to assist State and local public health departments and laboratories to sustain vital resistance reporting through CDC’s National Healthcare Safety Network (NHSN), as well as to identify and better characterize COVID-19 related antibiotic use, emergent resistance patterns to bacterial co-infections, and optimized treatment protocols to improve outcomes for COVID-19 infected patients. 

COVID-19 and antimicrobial resistance each pose grave threats to the public health.  In addition to actions to address each separately, we urge CDC to take further action to understand and respond to their combined threat.

Sincerely yours,

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