Generated Summary
The document is the Centers for Disease Control and Prevention’s (CDC) report, “Antibiotic Resistance Threats in the United States, 2019.” This report, the second of its kind, provides an overview of the threat of antibiotic resistance (AR) in the United States, focusing on the burden of antibiotic-resistant germs on human health, actions needed to address the challenge, and opportunities for detection and treatment. The report employs a variety of methods, including data from electronic health databases, to assess the national burden of 18 key antibiotic-resistant germs, categorized into urgent, serious, and concerning threats. The study’s scope encompasses healthcare, community, and environmental settings, recognizing the interconnectedness of these areas in the spread and impact of AR. The report emphasizes the ongoing need for coordinated, aggressive action and a One Health approach to combat this global public health crisis, which includes preventing infections, slowing the development of resistance, and stopping the spread of resistance.
Key Findings & Statistics
- More than 2.8 million antibiotic-resistant infections occur in the United States each year.
- More than 35,000 people die annually as a result of antibiotic-resistant infections.
- Nearly 223,900 people required hospital care for C. difficile in 2017, leading to at least 12,800 deaths.
- Deaths from antibiotic resistance are decreasing since the 2013 report, suggesting that prevention efforts in hospitals are working.
- Vancomycin-resistant Enterococcus infections decreased by 41% since 2013.
- Multidrug-resistant Pseudomonas aeruginosa infections decreased by 29% since 2013.
- Methicillin-resistant Staphylococcus aureus (MRSA) infections decreased by 21% since 2013.
- Carbapenem-resistant Acinetobacter infections decreased by 33% since 2013.
- Drug-resistant Candida infections decreased by 25% since 2013.
- Erythromycin-resistant invasive group A strep infections increased by 315%.
- Drug-resistant Neisseria gonorrhoeae infections increased by 124%.
- ESBL-producing Enterobacteriaceae infections increased by 50%.
- Antibiotic courses prescribed annually for infections that don’t need antibiotics: 47 million.
- In 2017, 1.7 million adults developed sepsis.
- In 2017, 1.2 million women had a cesarean section (C-section).
- More than 30 million people have diabetes.
- In 2016, over 33,000 organ transplants were performed.
- In 2016, more than 500,000 patients received dialysis treatment.
- Around 650,000 people receive outpatient chemotherapy each year.
- Antibiotic use in outpatient settings declined by 5% from 2011-2016.
- Outpatient prescribing to children also declined by 16% from 2011-2017.
Other Important Findings
- The report lists 18 germs categorized into urgent, serious, and concerning threats to human health.
- The spread of antibiotic resistance is a One Health issue, spreading through people, animals, and the environment.
- Germs spread through various means, including close contact, air, contaminated water, contaminated surfaces, animals, and sexual contact.
- Preventing the spread of germs and improving antibiotic use are key strategies to combat antibiotic resistance.
- CDC has taken aggressive action in coordination with other Federal agencies, state and local health departments, patients, public health partners, and the private sector.
- Antibiotics are critical tools for treating infections, but their use can contribute to the development of antibiotic resistance.
- CDC is working to expand detection and surveillance capabilities, including through the AR Lab Network, to rapidly identify and respond to threats.
- CDC’s Containment Strategy is used to stop the spread of new or emerging resistance.
- Vaccines, therapeutics, and diagnostics are essential tools in combating antibiotic resistance.
- Improving antibiotic stewardship is crucial for preserving the effectiveness of antibiotics.
Limitations Noted in the Document
- Data limitations led to an underestimation of the true burden of antibiotic resistance in the 2013 report.
- The use of ICD diagnosis codes or death certificate data may underreport the true burden of cases and deaths from antibiotic resistance.
- The estimates are approximations of the true burden of illness, and the financial cost of antibiotic-resistant infections is not estimated on a national scale.
- Data sources and methods varied by germ, which may affect the comparability of estimates.
- The report does not include viruses or parasites.
- The development of new antibiotics is slow and cannot be solely relied upon to address the problem.
- Most current diagnostic technologies are effective but costly, time-consuming, and may not detect emerging resistance markers.
Conclusion
The “Antibiotic Resistance Threats in the United States, 2019” report underscores the severity and complexity of the antibiotic resistance crisis. The document details the ongoing threat to public health and the importance of immediate and comprehensive action. The report highlights the significant strides made in addressing this threat, while emphasizing the urgent need for continued innovation and collaboration. The CDC highlights the importance of several strategies, including infection prevention and control, antibiotic stewardship, and the development of new diagnostics and treatments. The report emphasizes that tackling antibiotic resistance is not solely a U.S. issue but a global crisis. The report also describes that action is needed across various settings, industries, and countries to protect people from antibiotic resistance threats. The findings stress that in order to stop antibiotic resistance, action must be taken through preventing infections, improving antibiotic use, and stopping the spread of resistance. The report’s key takeaway is the need for a multi-faceted approach, including prevention, containment, and antibiotic stewardship. The report states that there is no safe place from antibiotic resistance. As the document states, “The problem will get worse if we do not act now, but we can make a difference.”