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COVID-19 restrictions limited interactions of people and resulted in lowered E. coli antimicrobial resistance rates

Title: COVID-19 restrictions limited interactions of people and resulted in lowered E. coli antimicrobial resistance rates
Authors: Collignon, Peter; Beggs, John; Robson, Jennifer
Source: JAC-Antimicrobial Resistance ; volume 6, issue 4 ; ISSN 2632-1823
Publisher Information: Oxford University Press (OUP)
Publication Year: 2024
Description: Background Antibiotic resistance is rising globally and is a major One Health problem. How much person-to-person transmission or ‘contagion’ contributes to the spread of resistant strains compared with antibiotic usage remains unclear. As part of its COVID-19 response, Australia introduced strict people movement restrictions in early 2020. Along with internal lockdown measures, movement of people into Australia from overseas was severely restricted. These circumstances provided a unique opportunity to examine the association of people movements with changes in resistance rates. Methods Monthly resistance data on over 646 000 Escherichia coli urine isolates from 2016 till 2023 were modelled for statistical changes in resistance trends during pre-lockdown, lockdown and post-lockdown periods. Data were available for three clinical contexts (community, hospital and aged-care facilities). Data were also available for antibiotic usage volumes and movements of people into Australia. Results In 2020, arrivals into Australia decreased by >95%. Antibiotic community use fell by >20%. There were sharp falls in trend rates of resistance for all antibiotics examined after restrictions were instituted. This fall in trend rates of resistance persisted during restrictions. Notably, trend rates of resistance fell in all three clinical contexts. After removal of restrictions, an upsurge in trend rates of resistance was seen for nearly all antibiotics but with no matching upsurge in antibiotic use. Conclusions Restricting the movement of people appeared to have a dramatic effect on resistance rates in E. coli. The resulting reduced person-to-person interactions seems more closely associated with changes in antibiotic resistance than antibiotic usage patterns.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/jacamr/dlae125
Availability: https://doi.org/10.1093/jacamr/dlae125; https://academic.oup.com/jacamr/article-pdf/6/4/dlae125/58875646/dlae125.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.EB0D2ADE
Database: BASE