The Centers for Disease Control and Prevention (CDC) has released its second "Antibiotic Resistance Threats in the United States" report and there are a number of significant issues raised.
The report, first published in 2013, is intended to serve as a reference for information on antibiotic resistance, provide current U.S. antibiotic resistance burden estimates, highlight emerging areas of concern and identify actions required to address these areas.
While the Infection Control Consulting Services (ICCS) team is still reviewing and digesting the report, here are 12 of its key takeaways:
Antibiotic-resistant bacteria and fungi cause nearly 2.9 million infections and 36,000 deaths in the United States annually. Essentially, a person in the United States gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies.
When Clostridioides difficile (C. diff), bacteria associated with antibiotic use is included in these figures, the U.S. toll of all the threats identified in the report exceeds 3 million infections and reaches nearly 49,000 deaths.
More people in the United States are dying from antibiotic-resistant infections than previously estimates.
CDC identifies 18 organisms associated with antibiotic resistance threats and organizes them into one of three categories: urgent, serious and concerning. Five organisms were identified as urgent, 11 as serious and two as concerning.
CDC developed a "watch list." This is a new resource intended to identify antibiotic-resistant threats with the potential to spread or become a challenge in the United States. Three organisms were included on the list.
CDC expressed its concerned about rising resistant infections in the community, including drug-resistant gonorrhea and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, which have shown increases since 2000.
CDC is alarmed about the emergence and spread of new forms of resistance, particularly shared among organisms through genetic mobile elements. CDC notes that these antibiotic-resistant organisms can share their resistance genes with other organisms and make them untreatable.
In 2018, CDC's Antibiotic Resistance Lab detected a resistant organism that required a public health investigation every four hours.
Prevention efforts have reduced deaths from antibiotic-resistant infections by 18% overall and by nearly 30% in hospitals since 2013.
Eighty-four percent of U.S. hospitals report having a stewardship program meeting all seven of CDC's "Core Elements of Hospital Antibiotic Stewardship."
Antibiotic prescribing in outpatient settings declined 5% from 2011 to 2016 and outpatient prescribing to children declined 16% from 2011 to 2017.
CDC proposed five core actions it feels will better prepare the United States for the resistance that will continue to emerge worldwide: 1) infection prevention and control; 2) tracking and data; 3) antibiotic use and access; 4) vaccines, therapeutics and diagnostics; and 5) environment and sanitation. As CDC notes, "Addressing [these] needs will help the United States and global community combat antibiotic resistance."
Review the 2019 "Antibiotic Resistance Threats in the United States" report here.