A new report from the Centers for Disease Control and Prevention (CDC), Antibiotic Resistance Threats in the United States, 2019 (2019 AR Threats Report), has found that there has been some progress in fighting the number and spread of infections caused by antibiotic-resistant bacteria and fungi.
In the CDC report, the term antibiotics describes the medications used to treat bacterial and fungal infections. Antibiotic resistance occurs when bacteria and fungi can survive and continue to cause infection despite treatment with one or more antibiotics.
The 2019 report notes that, since the first AR report in 2013, prevention efforts have reduced deaths from antibiotic resistant infections by 18% in general and by 30% in hospitals. In recent years, infections from five bacteria and fungi considered to be serious health threats have decreased, while infections caused by carbapenem-resistant Enterobacteriaceae (CRE), deemed an urgent threat, have remained stable.
Although this news is encouraging, the number of people affected by these serious infections is still too high, notes the CDC. The 2019 report shows that annually about 2.8 million people develop infections caused by resistant bacteria and fungi and 35,000 die. This means that, on average, someone in the U.S. develops an antibiotic-resistant infection every 11 seconds and someone dies of one every 15 minutes.
The CDC is also concerned about the increase in resistant infections outside of healthcare settings—in the community—which puts more people at risk. For example, drug-resistant gonorrhea infections have been on the rise since year 2000.
"The new AR Threats Report shows us that our collective efforts to stop the spread of germs and preventing infections is saving lives," says Robert R. Redfield, M.D., director of the Centers for Disease Control and Prevention, in a press release. "The 2013 report propelled the nation toward critical action and investments against antibiotic resistance. [This new] report demonstrates notable progress, yet the threat is still real. Each of us has an important role in combating it."
The overuse and inappropriate use of antibiotics (e.g., prescribing antibiotics when they are not needed, such as for viral infections) exposes bacteria to these drugs unnecessarily and the bacteria may develop resistance. When a serious infection occurs later, such as bacterial pneumonia, the antibiotics are no longer effective against the bacteria that were previously exposed and became resistant. This is a big problem because without effective antibiotics, common infections could become life-threatening once again. (For more details, read the in-depth article on Antibiotic Resistance in Bacteria.) Other microbes like viruses (e.g., flu, HIV) and parasites can also become resistant to drugs used to treat them, but the CDC’s report does not include them.
Like the 2013 report, the new report lists microbes according to three categories: urgent, serious, and concerning. Urgent and serious threats require aggressive monitoring and prevention strategies. Concerning threats require monitoring and response to occasional outbreaks of infections. They have a lower risk of occurring or there are more drug treatments remaining for those infections. Notable changes in the 2019 lists include:
- Two new urgent threats have been identified. The drug-resistant fungus Candida auris and the bacterium carbapenem-resistant Acinetobacter have caused outbreaks in healthcare settings (e.g., hospitals, nursing homes) and are often resistant to more than one group of antimicrobial medications (carbapenem is an antibiotic).
- A new watch list has been added, listing three microbes that do not yet have widespread resistance or that are not yet well understood. The CDC and other public health officials are monitoring them closely:
- Azole-resistant Aspergillus fumigatus—a fungus that can cause life-threatening infections in people with weakened immune systems (azoles are a type of antifungal medication)
- Drug-resistant Mycoplasma genitalium—a sexually transmitted disease (STD) that has few drug options for treatment
- Drug-resistant Bordetella pertussis—causes a respiratory infection commonly called whooping cough that sometimes has serious complications, especially in babies
Public health officials have implemented several strategies to combat antibiotic resistant infections, according to the CDC. Some examples include working to develop better diagnostic tests, rapidly detecting and identifying antibiotic resistant bacteria and fungi, containing the spread of antibiotic resistant infections, increasing vaccinations, and improving the use of antibiotics.
What you can do
It is not possible to completely protect yourself from antibiotic resistant infections, but there are steps you can take to lower your risk as well as to help combat antibiotic resistance. Among the recommendations from the CDC:
- Talk to your healthcare practitioner and know your risk for certain infections and sepsis. Take care of chronic conditions like diabetes (e.g., controlling blood sugar levels) to lower your risk. Learn to recognize symptoms of infections.
- Keep your hands clean; wash them frequently and well with soap and water.
- Get recommended vaccinations.
- Use antibiotics appropriately. Take all the antibiotic pills you are prescribed. Don't save antibiotics for later or use someone else's prescription.
- Know that antibiotics don’t work for viral infections, so don’t ask your healthcare practitioner for antibiotics when you have a cold or other infection commonly caused by a virus, such as a sinus infection.