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February 01, 2020

Drug-resistant bacteria hurt more people than previously reported

Published on January 15, 2020

Antimicrobial-resistant bacteria sicken more people than previously known, although improved infection controls are reducing deaths.

Officials with the Centers for Disease Control and Prevention reported in November 2019 that people in the U.S. acquire about 2.9 million drug-resistant infections each year, killing about 36,000 of them. People in hospitals face higher risk, although infection prevention programs have reduced the number of hospital-acquired antimicrobial-resistant infections by 27% from 2012-17.

“Nonetheless, without continued action and vigilance these gains will only be temporary,” the report states.

Enterobacteriaceae
Extended-spectrum beta-lactamase–producing Enterobacteriaceae
Microscopic view of MRSA
Methicillin-resistant Staphylococcus aureus (Images courtesy of CDC)


The report, “Antibiotic Resistance Threats in the United States 2019,” follows up on a 2013 report that indicated antimicrobial-resistant infections then sickened more than 2 million people each year and killed at least 23,000. Using methods revised for the 2019 edition, CDC officials estimate the true burden at the time of the 2013 report was closer to 2.6 million drug-resistant infections and 44,000 deaths.

Those revised numbers indicate drug-resistant infections have risen even though the number of deaths has declined.

“Antibiotic resistance can affect any person, at any stage of life,” the report states.

The report describes the dangers and effects of the most deadly drug-resistant pathogens. Methicillin-resistant Staphylococcus aureus killed an estimated 10,600 people in 2017, extended-spectrum beta-lactamase–producing Enterobacteriaceae killed 9,100, vancomycin-resistant enterococci killed 5,400, drug-resistant Streptococcus pneumoniae killed 3,600, and multidrug-resistant Pseudomonas aeruginosa killed 2,700.

The report also notes that, in addition to the 36,000 deaths from drug-resistant infections, about 12,800 people died in 2017 from Clostridioides difficile infections. C difficile infections tend to occur among people during or after antimicrobial treatments, which can wipe out microbes that protect against infections.

The report indicates 84% of U.S. hospitals use antimicrobial stewardship programs that meet CDC guidance on such programs. Antimicrobial prescribing in outpatient settings also declined 5% from 2011-16, and outpatient prescribing for children declined 16% from 2011-17, the report states.

The report authors urge use of public health interventions such as improving hygiene, increasing vaccination rates, adding biosecurity on farms, and improving responses to contain germs with unusual genes.

The authors also said veterinarians can help reduce selection pressure for drug resistance by preventing disease and improving antimicrobial use. The recommended interventions include improving vaccination rates, using proper animal husbandry and biosecurity, washing hands, disinfecting equipment, maintaining records of treatments and outcomes, using diagnostic tests to assess antimicrobial needs, following prescribing guidance and standards, disposing of unused or expired drugs, and committing to drug stewardship.