One of the greatest threats to public health today, in the United States and around the world, isn’t a new exotic hazard. It’s antibiotic resistance: the potential failure of one of our most important and well-known disease-fighting tools.
The latest Antibiotic Resistance Threats Report, recently published by the Centers for Disease Control and Prevention, shows that antibiotic-resistant (AR) infections — when germs defeat the drugs designed to kill them — cause more than 35,000 deaths each year in the United States.
While data are limited, the situation is even more worrisome elsewhere in the world. Microbes resistant to antibiotics and antifungal drugs can spread easily from person to person and country to country, and can cause hard-to-treat or entirely untreatable infections.
Addressing the threat of antimicrobial resistance helps protect our nation’s health and global health security.
The CDC’s first AR Threats Report sounded the alarm in 2013, highlighting the 18 most dangerous bacteria and fungi that cause resistant infections in the United States. The report grabbed the attention of policymakers and world leaders and set off a series of multinational efforts. Congress made sizable investments that spurred unprecedented action nationwide. Leadership from the Department of Health and Human Services and the CDC propelled our nation’s commitment to combat antibiotic resistance, broadening our resources by enlisting more than 350 partners ranging from international nongovernmental organizations to private industry, including fast-food restaurants, the pet-supply sector, and more.
We continue to lead the U.S. public health response to combat antibiotic resistance through a three-pronged strategy: detection, prevention, and innovation. New data show our efforts over the past few years are saving lives. The new AR Threats Report finds an overall 18% reduction in deaths from antibiotic-resistant infections since the 2013 report, and a nearly 30% reduction in hospital deaths.
This success is undoubtedly driven by a collective effort to prevent infections in the first place, as well as efforts to decrease inappropriate antibiotic use. Health care providers vigilantly practicing infection prevention in hospitals have held the line and stopped the spread of a number of highly concerning antibiotic threats that had been spreading across the United States in the 2000s. Family doctors recommending vaccines have protected their patients from pneumococcal infections and potential adverse effects of antibiotics that would be needed to treat them. Lab technicians and disease detectives nationwide have uncovered reservoirs of unusual germs, like the fungus Candida auris and “nightmare” bacteria like carbapenem-resistant Enterobacteriaceae, that have yet to become common in the United States, stomping out the spark of resistance before the fire takes hold and takes lives.
Unfortunately, new data show that major challenges remain. The very nature of antibiotic resistance means that new threats are constantly emerging. Candida auris was not listed in the 2013 report because the world was not yet aware of its significance. Today, it is an urgent threat to the health of our nation and nations across the globe: More than 1 in 3 patients with invasive C. auris infection die. Rapid identification and response to this resistant fungus has been effective in many places, but we must remain vigilant to continue protecting Americans.
The CDC also notes increasing concern for several resistant threats in the community outside of medical settings: cases of drug-resistant gonorrhea (which can cause infertility, among other serious health effects) and group A strep (which can cause strep throat, skin infections, and sometimes more severe disease) have each more than doubled since the last report. Certain types of Enterobacteriaceae, which can cause antibiotic-resistant urinary tract infections, are also on the rise. Finally, comprehensive prevention and response is needed to ensure that the three Watch List threats — drug-resistant Aspergillus fumigatus, Mycoplasma genitalium, and Bordetella pertussis, which are not yet prevalent in the U.S. but are being monitored — do not become commonplace here.
The new AR Threats Report gives us hope that, despite the unrelenting dangers posed by resistance to antibiotics and other antimicrobial drugs, our comprehensive strategy to prevent infections is effective against this global threat. The U.S. will take swift public health action to save lives, but everyone must join us in waging this war: Use antibiotics only as your doctor or veterinarian prescribes. Keep your hands clean, cover wounds, and get recommended vaccines with confidence. Prepare food safely. Use safe sex practices.
The federal government will continue to do its part. Across HHS, we are supporting the development of innovative new antibiotics, promoting the safe use of our existing tools, and ensuring antibiotic resistance remains a global priority.
By coupling innovation with a now-proven strategy of commonsense interventions, we can win real victories. And by maintaining vigilance, spurring innovation, and sustaining global partnerships, we are protecting lives and the promise of modern medicine for generations to come.
Alex M. Azar II is secretary of the Department of Health and Human Services. Robert R. Redfield, M.D., is director of the Centers for Disease Control and Prevention.