Objectives: The COVID-19 pandemic has had a substantial impact on health systems. The WHO Antimicrobial Resistance (AMR) Surveillance and Quality Assessment Collaborating Centres Network conducted a survey to assess the effects of COVID-19 on AMR surveillance, prevention and control.
Methods: From October to December 2020, WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) national focal points completed a questionnaire, including Likert scales and open-ended questions. Data were descriptively analysed, income/regional differences were assessed and free-text questions were thematically analysed.
Results: Seventy-three countries across income levels participated. During the COVID-19 pandemic, 67% reported limited ability to work with AMR partnerships; decreases in funding were frequently reported by low- and middle-income countries (LMICs; P < 0.01). Reduced availability of nursing, medical and public health staff for AMR was reported by 71%, 69% and 64%, respectively, whereas 67% reported stable cleaning staff availability. The majority (58%) reported reduced reagents/consumables, particularly LMICs (P < 0.01). Decreased numbers of cultures, elective procedures, chronically ill admissions and outpatients and increased ICU admissions reported could bias AMR data. Reported overall infection prevention and control (IPC) improvement could decrease AMR rates, whereas increases in selected inappropriate IPC practices and antimicrobial prescribing could increase rates. Most did not yet have complete data on changing AMR rates due to COVID-19.
Conclusions: This was the first survey to explore the global impact of COVID-19 on AMR among GLASS countries. Responses highlight important actions to help ensure that AMR remains a global health priority, including engaging with GLASS to facilitate reliable AMR surveillance data, seizing the opportunity to develop more sustainable IPC programmes, promoting integrated antibiotic stewardship guidance, leveraging increased laboratory capabilities and other system-strengthening efforts.
Bibliographical noteFunding Information: This work was supported by a working group belonging to the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network. It was led by the coordinator of the Network at the Robert Koch Institute in Berlin, Germany, who received funding from the Global Protection Programme (GHPP) at the German Federal Ministry of Health.
Open Access: This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact firstname.lastname@example.org
Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Citation: Sara Tomczyk, Angelina Taylor, Allison Brown, Marlieke E A de Kraker, Aiman El-Saed, Majid Alshamrani, Rene S Hendriksen, Megan Jacob, Sonja Löfmark, Olga Perovic, Nandini Shetty, Dawn Sievert, Rachel Smith, John Stelling, Siddhartha Thakur, Ann Christin Vietor, Tim Eckmanns, the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network, Impact of the COVID-19 pandemic on the surveillance, prevention and control of antimicrobial resistance: a global survey, Journal of Antimicrobial Chemotherapy, Volume 76, Issue 11, November 2021, Pages 3045–3058,