Pandemic Disruptions and Post-COVID Patterns of Antimicrobial Resistance-Associated Notifications in Sweden

This nationwide Swedish study (2015–2025) assessed how the COVID-19 pandemic influenced antimicrobial resistance (AMR) notifications for ESBL-CARBA, VRE, and MRSA. During the pandemic (2020–2021), notification rates for VRE and MRSA declined significantly, while ESBL-CARBA remained unchanged. In the post-COVID period (2022–2025), ESBL-CARBA notifications increased markedly—more than doubling compared to pre-pandemic levels—whereas VRE returned to baseline and MRSA remained persistently lower. These divergent trends likely reflect a combination of factors, including changes in healthcare use, infection control practices, screening intensity, and transmission dynamics. Importantly, the absence of testing volume data limits interpretation, as increased notifications may partly reflect resumed or intensified screening rather than true rises in resistance.