Emerging Threat: Antimicrobial Resistance Proliferation During Epidemics — A Case Study of the SARS-CoV-2 Pandemic in South Brazil

The escalating global concern of antimicrobial resistance poses a significant challenge to public health. This study delved into the occurrence of resistant bacteria and antimicrobial-resistant genes in the waters and sediments of urban rivers and correlated this emergence and the heightened use of antimicrobials during the COVID-19 pandemic. Isolating 45 antimicrobial-resistant bacteria across 11 different species, the study identifies prevalent resistance patterns, with ceftriaxone resistance observed in 18 isolates and ciprofloxacin resistance observed in 13 isolates. The detection of extended-spectrum β-lactamases, carbapenemases, and acquired quinolone resistance genes in all samples underscores the gravity of the situation. Comparison with a pre-pandemic study conducted in the same rivers in 2019 reveals the emergence of previously undetected new resistant species, and the noteworthy presence of new resistant species and alterations in resistance profiles among existing species. Notably, antimicrobial concentrations in rivers increased during the pandemic, contributing significantly to the scenario of antimicrobial resistance observed in these rivers. We underscore the substantial impact of heightened antimicrobial usage during epidemics, such as COVID-19, on resistance in urban rivers. It provides valuable insights into the complex dynamics of antimicrobial resistance in environmental settings and calls for comprehensive approaches to combat this pressing global health issue, safeguarding both public and environmental health. Environmental Implication This article pioneers a crucial exploration into the environmental ramifications of heightened antimicrobial usage during the SARS-CoV-2 pandemic in urban rivers. The detection of extended-spectrum β-lactamases, carbapenemases, and acquired quinolone resistance genes in all samples, along with altered profiles compared to the pre-pandemic era, accentuates the urgency of this work. The study uniquely correlates increased antimicrobial concentrations in rivers with emerging resistance, emphasizing the environmental relevance of the escalating global antimicrobial resistance crisis. By shedding light on the intricate interplay between pandemics, antimicrobial usage, and environmental impact, this research advocates for comprehensive strategies to safeguard public health and the environment.