Antimicrobial resistance (AMR) data from 2012 through 2022 shows that the number of drug-resistant infections in hospitals has largely gone down, though it is still significant, according to a [study](https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831512) published March 14 in _JAMA Network Open._
Scientists evaluated six bacterial pathogens linked with healthcare settings that made up nearly 570,000 drug-resistant infections in United States’ hospital patients in 2022. They decreased from a 2017 estimate of 600,000 infections.
The pathogens studied have few treatment options and include [methicillin-resistant _Staphylococcus aureus_ (MRSA)](https://www.mcknights.com/news/higher-mrsa-rates-linked-to-lower-nurse-staffing-levels-in-nursing-homes-study-shows/), vancomycin-resistant _Enterococcus_ (VRE), extended-spectrum cephalosporin-resistant _Escherichia coli_ and _Klebsiella pneumoniae_ (ESCR-EK), carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant _Acinetobacter_ spp (CRAsp) and multidrug-resistant (MDR) _Pseudomonas aeruginosa._
Rates of several drug-resistant community- and hospital-onset infections fell during the first part of the study period but went up when the COVID-19 pandemic came on the scene.
The team examined data based on people who had cultures showing organisms of interest. Community-onset cases included cultures collected before day 4 of hospitalization, while cases starting in the hospital were defined as those with cultures obtained on day 4 or later.
Data was derived from 332 to 606 hospitals per year from 2012 through 2022 and more than 7 million clinical cultures. Of infections, 77% started in the community and 23% began in hospitals. Among pathogens, MRSA and ESCR-EK were most common.
Overall, the rate of resistant infections decreased from 209.6 to 179.6 per 10,000 hospitalizations from 2012 through 2022. The decline was evident from 2012 to 2016. The rate then evened out from 2016 to 2018 and started to increase starting in 2019. By 2020, cases were at 197 cases per 10,000 hospitalizations. Then there was another decline through 2022.
While rates of hospital-onset MRSA, VRE, CRE, CRAsp and MDR _P aeruginosa_ declined between 2012 and 2019, hospital-onset cases of all six pathogens increased from 2020 to 2021. COVID-19–related hospital surges drove the rise, the authors wrote.
“Changes to healthcare use during the COVID-19 pandemic, such as decreases in overall admissions, surges in high-risk patients with COVID-19 and higher proportions of patients who were sicker and did not have COVID-19 contributed to increased hospital-onset resistant case rates,” the authors wrote.
The findings show the need for new strategies to reduce resistant pathogens, the authors pointed out.