COVID-19: Why Did Drug-Resistant Hospital Infections
Quick Facts
What did CDC find about drug-resistant hospital infections?
COVID-19 disrupted progress against infections that can withstand antimicrobial treatment. CDC's 2022 special report found that hospital-onset resistant infections and associated deaths each increased by at least 15% between 2019 and 2020 across seven tracked pathogens. These are historical surveillance findings, rather than measurements of infection rates in October 2026. [CDC's COVID-19 and antimicrobial resistance overview](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/covid-19.html).
A subsequent CDC analysis examined six resistant bacterial threats, including carbapenem-resistant Enterobacterales, resistant Acinetobacter and multidrug-resistant Pseudomonas aeruginosa. Their combined hospital-onset infection burden increased by 20% during the pandemic compared with the pre-pandemic period, peaked in 2021 and remained elevated in 2022. Rates for five of the six threats remained above their pre-pandemic levels in 2022; MRSA was the exception. This combined figure does not mean that every organism increased equally or that each hospital patient faced a 20% higher risk. [CDC's analysis of antimicrobial resistance in 2021–2022](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html).
Why did a viral pandemic worsen antibiotic resistance?
Antibiotics cannot treat SARS-CoV-2, the virus responsible for COVID-19, but clinicians faced uncertainty about accompanying bacterial infections. CDC reports that almost 80% of patients hospitalized with COVID-19 received an antibiotic between March and October 2020. Some patients needed bacterial treatment; that prescribing figure alone cannot establish whether an individual prescription was appropriate. Meanwhile, longer hospital stays, greater use of ventilators and catheters, staffing shortages and equipment challenges made infection prevention harder. [CDC's account of the pandemic's effects](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/covid-19.html).
Antibiotic exposure and transmission contribute in different ways. Antibiotics can eliminate susceptible bacteria while resistant organisms survive and multiply. Those organisms can then spread, and some bacteria can transfer resistance genes to other bacteria. Resistance develops in microbes, not in a patient's body. This explains why protecting antibiotic effectiveness requires both careful prescribing and measures that prevent infections from passing between people. [CDC's explanation of antimicrobial resistance](https://www.cdc.gov/antimicrobial-resistance/about/).
How can treatment advances help patients with resistant infections?
The treatment implications extend beyond choosing a more powerful antibiotic. Infectious Diseases Society of America guidance identifies newer antibiotic–enzyme inhibitor combinations as preferred options for certain invasive infections caused by Enterobacterales producing KPC, an enzyme that disables important antibiotics. Meropenem-vaborbactam is one example. Such combinations can protect an antibiotic from particular bacterial enzymes, but they do not overcome every resistance mechanism. Results against one resistant organism cannot automatically be applied to another. [IDSA guidance on resistant bacterial infections](https://www.idsociety.org/practice-guideline/amr-guidance/).
IDSA recommends matching treatment to laboratory susceptibility results and considering infection location, illness severity, previous cultures, recent antibiotic exposure and patient factors such as kidney disease. Newer treatments have improved options for some infections, but resistance can also emerge during their use. The clinical implication of the CDC findings is that treatment innovation and infection prevention must advance together: preventing an infection avoids the need to expose a patient to another antibiotic course. [IDSA treatment guidance](https://www.idsociety.org/practice-guideline/amr-guidance/) and [CDC prevention priorities](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html).
Frequently Asked Questions
No. Resistance is a property of bacteria and other microbes, not an inevitable consequence of a COVID-19 infection. CDC's findings describe population-level changes in hospital infections.
Often, yes. Resistance to one antibiotic does not necessarily mean resistance to every treatment. Some infections nevertheless have very limited options, making identification of the organism and specialist input important.
No. Treatment depends on which drug is active against the organism, where the infection is located and the patient's circumstances. A newer medicine may offer no advantage when an established treatment remains effective.
Yes. Resistant organisms can spread between people and through healthcare environments. Previous antibiotic use is not required for someone to acquire them.
No. The figures discussed here describe 2019–2022. They establish a pandemic-era setback but do not measure the current burden or an individual patient's risk.
References
- Centers for Disease Control and Prevention. [COVID-19 & Antimicrobial Resistance](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/covid-19.html). February 5, 2025.
- Centers for Disease Control and Prevention. [Antimicrobial Resistance Threats in the United States, 2021–2022](https://www.cdc.gov/antimicrobial-resistance/data-research/threats/update-2022.html). June 2, 2025.
- Centers for Disease Control and Prevention. [About Antimicrobial Resistance](https://www.cdc.gov/antimicrobial-resistance/about/). January 31, 2025.
- Infectious Diseases Society of America. [IDSA 2026 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections](https://www.idsociety.org/practice-guideline/amr-guidance/). July 30, 2026.