With all eyes on the coronavirus, drug-resistant infections creep in

As COVID-19 took hold over the past year, hospitals and nursing homes used and reused scarce protective equipment — masks, gloves, gowns. This desperate frugality helped prevent the airborne transfer of the virus.

But it also appears to have helped spread a different set of germs — drug-resistant bacteria and fungi — that have used the chaos of the pandemic to grow opportunistically in health care settings around the globe.

These bacteria and fungi, as COVID-19 does, prey on older people, the infirm and those with compromised immune systems. The bacteria can cling tenaciously to clothing and medical equipment, which is why nursing homes and hospitals before the pandemic increasingly were focused on cleaning rooms and changing gowns to prevent their spread.

That emphasis all but slipped away amid an allconsuming focus on the coronavirus. In fact, experts warn, the changes in hygiene and other practices caused by the COVID-19 fight are likely to have contributed to the spread of these drug-resistant germs.

“Seeing the world as a one-pathogen world is really problematic,” said Dr. Susan S. Huang, an infectious-disease specialist at the University of California-Irvine Medical School, noting that the nearly singular focus on the pandemic appears to have led to more spread of drug-resistant infection. “We have every reason to believe the problem has gotten worse.”

A few data points reinforce her fears, including isolated outbreaks of various drug-resistant infections in Florida, New Jersey and California, as well as in India, Italy, Peru and France. Overall figures have been hard to track because many nursing homes and hospitals simply stopped screening for the germs as resources were diverted to COVID-19.

When even modest screening picked up again early in the summer, the results suggested that certain drug-resistant organisms had taken root and spread. Particularly troublesome have been growing case counts of a fungus called

Candida auris, which authorities had tried to fight before the pandemic with increased screening, isolation of infected patients and better hygiene.

These intensive efforts had limited the spread of

C. auris to a handful of cases in Los Angeles County. Now there are around 250, said Dr. Zachary Rubin, who leads the county’s infection-control efforts at health care facilities.

“We saw a blooming in

Candida auris ,”saidRubin, who attributed the change to a handful of factors, notably the challenges in testing for the germ when so many testing resources went toward COVID-19.

Noxious drug-resistant bacteria are surfacing too, including Carbapenem-resistant Acinetobacter baumannii, which is considered an “urgent health threat” by the Centers for Disease Control and Prevention. In December, the CDC reported a cluster of

Acinetobacter baumannii

during a surge of COVID-19 patients in an urban New Jersey hospital with about 500 beds. The hospital was not identified. And hospitals in Italy and Peru saw the spread of the bacteria

Klebsiella pneumoniae.

In an acknowledgment of the issue, three major medical societies sent a letter Dec. 28 to the Centers for Medicare and Medicaid Services asking for a temporary suspension of rules that tie reimbursement rates to hospital-acquired infections. The three groups — the Society of Healthcare Epidemiology of America, the Society of Infectious Diseases Pharmacists and the Association for Infection Control and Epidemiology — feared that the infection rates may have risen because of COVID-19.

“Patient care staffing, supplies, care sites and standard practices have all changed during this extraordinary time,” the letter stated.