Antibiotic Resistance Threats in the United States, 2013

This report, Antibiotic resistance threats in the United States, 2013 gives a first-ever snapshot of the burden and threats posed by the antibiotic-resistant germs having the most impact on human health. 

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

Antibiotic-resistant infections can happen anywhere. Data show that most happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.

 

What's in the Report

Foreword[page 5]

Executive Summary[page 6]

Section 1: The Threat of Antibiotic Resistance[page 11]

• Introduction[page 11]

• National Summary Data[page 13]

• Cycle of Resistance Infographics[page 14]

• Minimum Estimates of Morbidity and Mortality from Antibiotic-Resistant 
  Infections[page 15]

• Limitations of Estimating the Burden of Disease Associated with Antibiotic-Resistant 
  Bacteria[page 18]

• Assessment of Domestic Antibiotic-Resistant Threats[page 20]

• Running Out of Drugs to Treat Serious Gram-Negative Infections[page 22]

• People at Especially High Risk[page 24]

• Antibiotic Safety[page 25]

• Gaps in Knowledge of Antibiotic Resistance[page 27]

• Developing Resistance: Timeline of Key Antibiotic Resistance Events[page 28]

Section 2: Fighting Back Against Antibiotic Resistance[page 31]

Four Core Actions to Prevent Antibiotic Resistance[page 31]

1. Preventing Infections, Preventing the Spread of Resistance[page 32]
   • CDC's Work to Prevent Infections and Antibiotic Resistance in
     Healthcare Settings[page 32]
   • CDC's Work to Prevent Antibiotic Resistance in the Community[page 34]
   • CDC's Work to Prevent Antibiotic Resistance in Food[page 36]
2. Tracking Resistance Patterns[page 39]
3. Antibiotic Stewardship: Improving Prescribing, Improving Use[page 41]
4. Developing New Antibiotics and Diagnostic Tests[page 44]

Section 3: Current Antibiotic Resistance Threats in the United States,
by Microorganism page 49]

Microorganisms with a Threat Level of Urgent

• Clostridium difficile[page 51]
• Carbapenem-resistant Enterobacteriaceae[page 53]
• Drug-resistantNeisseria gonorrhoeae[page 55]

Microorganisms with a Threat Level of Serious

• Multidrug-resistant Acinetobacter[page 59]
• Drug-resistant Campylobacter[page 61]
• Fluconazole-resistant Candida (a fungus)[page 63]
• Extended spectrum β-lactamase producing Enterobacteriaceae (ESBLs)[page 65]
• Vancomycin-resistantEnterococcus (VRE)[page 67]
• Multidrug-resistant Pseudomonas aeruginosa[page 69]
• Drug-resistant non-typhoidal Salmonella[page 71]
• Drug-resistant Salmonella Typhi[page 73]
• Drug-resistant Shigella[page 75]
• Methicillin-resistant Staphylococcus aureus (MRSA)[page 77]
• Drug-resistant Streptococcus pneumoniae[page 79]
• Drug-resistant tuberculosis[page 81]

Microorganisms with a Threat Level of Concerning

• Vancomycin-resistant Staphylococcus aureus (VRSA)[page 85]
• Erythromycin-resistant Group A Streptococcus[page 87]
• Clindamycin-resistant Group B Streptococcus[page 89]

Technical Appendix[page 93]

Glossary[page 107]

Acknowledgements[page 112]