Generated Summary
This report, “Antibiotic Resistance Threats in the United States, 2013,” published by the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC), provides a comprehensive overview of the complex problem of antibiotic resistance. The report aims to raise awareness of the threat posed by antibiotic resistance and to encourage immediate action to address it. The study focuses on bacteria causing severe human infections and the antibiotics used to treat them, also including Candida, a fungus. The methodology involves cross-cutting and bacteria-specific summaries of cross-cutting and bacteria- specific antibiotic resistance topics. The report provides a national assessment of the most dangerous antibiotic resistance threats, summarizing the burden of illness, levels of concern, and the remaining effectiveness of antibiotics. It is designed to be accessible to various audiences and serves as a reference for information on antibiotic resistance, offering technical references and links. The report highlights the scope of antibiotic resistance and its impact, emphasizing the alarming consequences of inaction. CDC estimates that in the United States, more than two million people are sickened every year with antibiotic-resistant infections, with at least 23,000 dying as a result. The estimates are based on conservative assumptions and are likely minimum estimates. The report also categorizes prioritized bacteria into three categories: urgent, serious, and concerning, informing public health interventions and strategies.
Key Findings & Statistics
- In the United States, at least 2 million people acquire serious infections with bacteria resistant to one or more antibiotics annually.
- At least 23,000 deaths occur each year as a direct result of antibiotic-resistant infections.
- Approximately 250,000 people each year require hospital care for Clostridium difficile (C. difficile) infections.
- At least 14,000 deaths per year in the United States are attributed to C. difficile infections.
- The total economic cost of antibiotic resistance to the U.S. economy has been estimated to be as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity reaching $35 billion a year (2008 dollars).
- More than two million people in the United States are sickened every year by antibiotic-resistant infections, resulting in at least 23,000 deaths.
- Regarding level of concern, CDC has — for the first time — prioritized bacteria in this report into one of three categories: urgent, serious, and concerning.
- Estimated minimum number of illnesses caused by antibiotic resistance: 2,049,442 illnesses.
- Estimated minimum number of deaths caused by antibiotic resistance: 23,000 deaths.
- Estimated minimum number of illnesses and deaths due to Clostridium difficile (C. difficile): 250,000 illnesses and 14,000 deaths.
- CDC estimates that more than two million people are sickened every year with antibiotic-resistant infections, resulting in at least 23,000 deaths.
- Carbapenem-resistant Enterobacteriaceae (CRE) infections: Estimated annual number of cases: 9,300; Estimated annual number of deaths: 610.
- Drug-resistant Neisseria gonorrhoeae: Estimated annual number of cases: 246,000; Estimated annual number of deaths: less than 5.
- Multidrug-resistant Acinetobacter: Estimated annual number of cases: 7,300; Estimated annual number of deaths: 500.
- Drug-resistant Campylobacter: Estimated annual number of cases: 310,000; Estimated annual number of deaths: 28.
- Drug-resistant Candida (fluconazole): Estimated annual number of cases: 3,400; Estimated annual number of deaths: 220.
- Extended-spectrum B-lactamase producing Enterobacteriaceae (ESBLs): Estimated annual number of cases: 26,000; Estimated annual number of deaths: 1,700.
- Vancomycin-resistant Enterococcus (VRE) infections: Estimated annual number of cases: 20,000; Estimated annual number of deaths: 1,300.
- Multidrug-resistant Pseudomonas aeruginosa infections: Estimated annual number of cases: 6,700; Estimated annual number of deaths: 440.
- Drug-resistant non-typhoidal Salmonella infections: Estimated annual number of cases: 100,000; Estimated annual number of deaths: 40.
- Drug-resistant Salmonella Typhi infections: Estimated annual number of cases: 3,800; Estimated annual number of deaths: less than 5.
- Drug-resistant Shigella infections: Estimated annual number of cases: 27,000; Estimated annual number of deaths: less than 5.
- Methicillin-resistant Staphylococcus aureus (MRSA) infections: Estimated annual number of cases: 80,000; Estimated annual number of deaths: 11,000.
- Drug-resistant Streptococcus pneumoniae infections: Estimated annual number of cases: 1,200,000; Estimated annual number of deaths: 7,000.
- Drug-resistant tuberculosis infections: Estimated annual number of cases: 1,042; Estimated annual number of deaths: 50.
- Vancomycin-resistant Staphylococcus aureus (VRSA) infections: Estimated annual number of cases: less than 5; Estimated annual number of deaths: less than 5.
- Erythromycin-resistant Group A Streptococcus infections: Estimated annual number of cases: 1,300; Estimated annual number of deaths: 160.
- Clindamycin-resistant Group B Streptococcus infections: Estimated annual number of cases: 7,600; Estimated annual number of deaths: 440.
- In the United States, more than two million people are sickened annually by antibiotic-resistant infections, with at least 23,000 deaths.
- About 63% of Acinetobacter infections are multidrug-resistant.
- An estimated 140,000 healthcare-associated Enterobacteriaceae infections occur annually, and about 9,300 are caused by CRE. Roughly 600 deaths are attributed to CRE.
- Approximately 26,000 healthcare-associated Enterobacteriaceae infections (19%) are caused by ESBL-producing Enterobacteriaceae, with 1,700 deaths.
- Invasive MRSA infections: 80,461 severe MRSA infections per year; 11,285 deaths from MRSA per year.
- Drug-resistant Salmonella Typhi infections: 3,800 infections per year; 620 hospitalizations; 620 deaths.
- Drug-resistant Salmonella: 1,200,000 Salmonella infections per year; $365,000,000 in medical costs.
- Clindamycin-resistant Group B Streptococcus: 7,600 drug-resistant Group B Strep infections; 440 deaths.
Other Important Findings
- Antibiotic resistance is a worldwide problem, with new forms spreading rapidly across international boundaries.
- The loss of effective antibiotics threatens the ability to fight infectious diseases and manage complications in vulnerable patients, especially those undergoing chemotherapy, dialysis, or organ transplantation.
- The use of antibiotics is the single most important factor leading to antibiotic resistance.
- Drug resistance related to viruses such as HIV and influenza is not included, nor is drug resistance among parasites such as those that cause malaria.
- CDC estimates that in the United States, more than two million people are sickened every year with antibiotic-resistant infections, with at least 23,000 dying as a result. The estimates are based on conservative assumptions and are likely minimum estimates.
- Regarding level of concern, CDC has — for the first time — prioritized bacteria in this report into one of three categories: urgent, serious, and concerning.
- CDC estimates that more than two million people are sickened every year with antibiotic-resistant infections, with at least 23,000 deaths.
- Bacteria will inevitably find ways of resisting the antibiotics we develop, which is why aggressive action is needed now to keep new resistance from developing and to prevent the resistance that already exists from spreading.
Limitations Noted in the Document
- The report’s estimates are approximations and may not fully represent the true burden of illness.
- Precise criteria for determining bacterial resistance to specific antibiotics are not standardized across all bacterial species.
- Attribution of deaths to antibiotic-resistant infections can be challenging due to the presence of co-existing illnesses.
- The methodology used may underestimate the impact of antibiotic resistance on mortality for some pathogens.
- Complete data from all types of infections are not available for all pathogens, and tracking is limited to more severe types of infections for some.
- The report does not provide a specific estimate for the financial cost of antibiotic-resistant infections, and the methods used in studies to estimate these costs are variable.
Conclusion
The “Antibiotic Resistance Threats in the United States, 2013” report underscores the urgent need for action in combating the growing threat of antibiotic resistance. The document emphasizes the critical role of effective antibiotics in modern medicine and the potential catastrophic consequences of their loss due to resistance. The findings from the CDC highlight the widespread impact of antibiotic resistance, emphasizing the need to prioritize and address the most dangerous threats. The report suggests several strategies to prevent and combat antibiotic resistance, including preventing infections, tracking resistance patterns, improving antibiotic prescribing practices, and developing new antibiotics and diagnostic tests. The four core actions to combat antibiotic resistance, highlighted by the report, are essential for slowing the development and spread of resistant infections. The report also stresses the importance of antibiotic stewardship, emphasizing the need for healthcare providers to use antibiotics responsibly and judiciously. The publication also indicates that aggressive action is needed to keep new resistance from developing and to prevent the resistance that already exists from spreading. The report also highlights that despite the limitations in estimating the burden of disease associated with antibiotic-resistant bacteria, the impact is significant and demands a comprehensive approach. Overall, the report’s final thoughts are clear: Only through concerted commitment and action will the nation ever be able to succeed in reducing this threat.