2019 Antibiotic Resistance Threats in the U.S.

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

You or a loved one – like 3 million people in the U.S. – may face an antibiotic-resistant infection.

The above statement is found in the Forward of a just-released CDC report: Antibiotic Resistance Threats in the United States – 2019.  This is the second such report of its kind – the first was in 2013.  It presents data about the top 18 pathogens that require our attention now.

“It emphasizes that antibiotic resistance is a One Health issue that can spread through people, animals, and the environment; threatens our most vulnerable friends and family members; and affects nearly every aspect of life.

Given the chance, these germs will infect our bodies, take up residence in our healthcare facilities, contaminate our food and water supplies, and move across our communities and around the globe. This report shows us, however, that the fight against antibiotic resistance, no matter how complex, is not hopeless.

To stop antibiotic resistance, our nation must:

Stop referring to a coming post-antibiotic era—it’s already here. You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy. The time for action is now and we can be part of the solution.

Stop playing the blame game. Each person, industry, and country can affect the development of antibiotic resistance. We each have a role to play and should be held accountable to make meaningful progress against this threat.

Stop relying only on new antibiotics that are slow getting to market and that, sadly, these germs will one day render ineffective. We need to adopt aggressive strategies that keep the germs away and infections from occurring in the first place.

Stop believing that antibiotic resistance is a problem “over there in someone else’s hospital, state, or country—and not in our own backyard. Antibiotic resistance has been found in every U.S. state and in every country across the globe. There is no safe place from antibiotic resistance, but everyone can take action against it. Take action where you can, from handwashing to improving antibiotic use.

The problem will get worse if we do not act now, but we can make a difference.

More than 2.8 million antibiotic-resistant infections occur in the United States each year, and more than 35,000 people die as a result. In addition, nearly 223,900 people in the United States required hospital care for C. difficile and at least 12,800 people died in 2017.”  Essentially, a person in the United States gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies.

This is truly an eye-opening 148-page read.  This report is absolutely loaded with critical information for all healthcare personnel.  Here’s an excerpt from page 4:

Urgent Threats

■ Carbapenem-resistant Acinetobacter

■ Candida auris (C. auris)

■ Clostridioides difficile (C. difficile)

■ Carbapenem-resistant Enterobacteriaceae (CRE)

■ Drug-resistant Neisseria gonorrhoeae (N. gonorrhoeae)

Serious Threats

■ Drug-resistant Campylobacter

■ Drug-resistant Candida

■ Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae

■ Vancomycin-resistant Enterococci (VRE)

■ Multidrug-resistant Pseudomonas aeruginosa (P. aeruginosa)

■ Drug-resistant nontyphoidal Salmonella

■ Drug-resistant Salmonella serotype Typhi

■ Drug-resistant Shigella

■ Methicillin-resistant Staphylococcus aureus (MRSA)

■ Drug-resistant Streptococcus pneumoniae (S. pneumoniae)

■ Drug-resistant Tuberculosis (TB)

Concerning Threats

■ Erythromycin-resistant group A Streptococcus

■ Clindamycin-resistant group B Streptococcus

Watch List

■ Azole-resistant Aspergillus fumigatus (A. fumigatus)

■ Drug-resistant Mycoplasma genitalium (M. genitalium)

■ Drug-resistant Bordetella pertussis (B. pertussis)

These charts are found on pages 16 and 17:

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Additional information about this report is found on this CDC website.

“In 2018, CDC proposed five core actions to better prepare the United States for the resistance that will continue to emerge worldwide (bolding added by me):

  • Infection prevention and control: Prevent infections and reduce the spread of germs
  • Tracking and data: Share data and improve data collection
  • Antibiotic use and access: Improve appropriate use of antibiotics, reduce unnecessary use (called antibiotic stewardship), and ensure improved access to antibiotics
  • Vaccines, therapeutics, and diagnostics: Invest in development and improved access to vaccines, therapeutics, and diagnostics for better prevention, treatment, and detection
  • Environment and sanitation: Keep antibiotics and antibiotic resistant threats from entering the environment through actions like improving sanitation and improving access to safe water”

I strongly encourage you to download and share this report with your Infection Preventionists, IDT members and Infection Prevention and Control as well as QAPI committees.