The Antibiotic Resistance Threats Report released by the U.S. Centers for Disease Prevention and Control today shows that while recent federal investments to combat antibiotic resistance have had meaningful impacts, the continued spread of infections that are not effectively treated by existing medicines pose deadly threats to patients and public health. As physicians and scientists on the front lines of a growing public health crisis, the Infectious Diseases Society of America urges federal policy makers to respond to the report's warning with investments and commitment to turning the tide of antibiotic resistance.
The 2.87 million annual antibiotic resistant infections in the United States estimated in the report reflect an increase of 270,000 from 2013 CDC estimates. The report's estimate that those infections led to the deaths of 35,900 people reflects a drop in mortality attributable to the significant investments made in hospital associated infection prevention, but also reflects an increase in the number of community acquired infections and deaths. With the inclusion of treatment resistant C. difficile infections – infections that cause life-threatening inflammation of the colon – the data is less encouraging, with about 3 million infections and just under 50,000 deaths linked to antibiotic resistance. In addition, without more comprehensive and rapid surveillance and data collection, the numbers of antibiotic resistant infections and deaths reported are likely to be underestimated, as they have been in previous reports.
The report also shows that the scope of the threats posed by antibiotic resistance continues to grow; while the agency's 2013 report listed three pathogens as urgent threats, the report released today lists five. Of particular concern are increased incidence of infections associated with extended-spectrum beta-lactamase -producing Enterobacteriaceae that can transform infections once easily treated in the outpatient setting into far more complicated infections requiring hospitalization.
Showing an apparent decrease in healthcare-associated antibiotic resistant infections, which are typically more deadly than community acquired infections, the report leaves room for optimism. Without the federal investments that have raised awareness and improved responses to antibiotic resistance in recent years, trends indicate that still higher numbers of antibiotic resistant infections leading to more deaths would have occurred. The investments made also have deepened our understanding of effective antibiotic stewardship and infection prevention strategies.
At the same time, the report shows an increase in community-acquired resistant infections, telling us that the work ahead continues to be complex and will demand a multipronged, One Health approach. Still critical are policies to strengthen immunization, increased funding for CDC to support infection prevention measures, antibiotic stewardship in all health care settings, and increased funding to support research that will further our understanding of resistance and help us evaluate our approaches. Investments in the necessary expert workforce will be essential to all of these steps. In addition, investments in improved surveillance of antibiotic resistant infections and more coordinated data collection will be critical to yielding more accurate measures of antibiotic resistant infections and resulting deaths in real time, to inform more effective responses.
For all of these measures, the continued evolution of pathogens resistant to medicines more than a half century old remains inevitable, making the research and development toward new antibiotics, and incentives to bring them to market, imperative.