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NARMS 2012 Human Isolates Final Report—Interactive Graphs

These six interactive graphs show the percentage of NARMS human isolates that are resistant to various antibiotics by year. Choose the pathogen and antibiotic to see how that bug-drug resistance has been trending since 1996.

Overview

For a complete list of antibiotics used for susceptibility testing and criteria used to define resistance in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages] refer to:

More Information:

Non-typhoidal Salmonella

Salmonella is a bacteria that typically causes two distinct disease syndromes, typhoid fever and routine gastrointestinal infections. Strains associated with routine gastrointestinal infections are referred to as “nontyphoidal Salmonella.”

Non-typhoidal Salmonella causes [PDF - 114 pages] approximately 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths each year in the United States. Physicians rely on drugs for treating patients with complicated Salmonella infections.

Resistance to two of these clinically important drugs, ceftriaxone (a cephem) and ciprofloxacin (a quinolone), has climbed in non-typhoidal Salmonella since 1996. In 2011, about 5% of non-typhoidal Salmonella tested by CDC were resistant to five or more types of drugs.

Interactive Graph and Data

Use this graph to view all non-typhoidal Salmonella isolates or selected Salmonella serotypes that exhibit clinically important, antibiotic resistance patterns, including: Enteritidis, Typhimurium, Newport, Heidelberg, and I 4,[5],12:i:-.
Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages] to view data on the graphs:


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Salmonella serotype Typhi

Salmonella is a bacteria that typically causes two distinct disease syndromes, typhoid fever and routine gastrointestinal infections. The strains of Salmonella associated with typhoid fever is referred to as “Salmonella serotype Typhi.”

Salmonella serotype Typhi [PDF - 114 pages]causes approximately 5,700 typhoid fever illnesses and 620 hospitalizations each year in the United States. Physicians rely on drugs such as ceftriaxone, azithromycin, and ciprofloxacin for treating patients with typhoid fever. CDC is seeing some level of resistance to ciprofloxacin in two-thirds of Salmonella serotype Typhi tested (the graph shows only the proportion with full resistance). CDC has not yet seen resistance to ceftriaxone or azithromycin in the United States, but this has been seen in other parts of the world.

CDC is seeing some level of resistance to ciprofloxacin in two-thirds of Salmonella serotype Typhi tested (the graph shows only the proportion with full resistance). CDC has not yet seen resistance to ceftriaxone or azithromycin in the United States, but this has been seen in other parts of the world.

Interactive Graph and Data
Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages] to view data on the graphs:


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Salmonella serotype Paratyphi A

Some strains of Salmonella cause paratyphoid fever, a potentially life-threatening disease similar to typhoid fever. Salmonella serotype Paratyphi A is the most commonly reported cause of paratyphoid fever. Physicians rely on drugs such as ceftriaxone (a cephem) and ciprofloxacin (a fluoroquinolone) to treat patients with paratyphoid fever.

Although full resistance to ciprofloxacin is low (as reflected in the graph below), some level of resistance is common. Nalidixic acid belongs to the same antibiotic class as ciprofloxacin, and resistance to this drug is a marker for some level of resistance to ciprofloxacin. CDC has not yet seen resistance to ceftriaxone among Paratyphi A isolates in the United States, but this has been reported in other parts of the world.

Interactive Graph and Data

Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages]


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Shigella

Shigella [PDF - 114 pages] causes approximately 500,000 diarrheal illnesses, 5,500 hospitalizations, and 40 deaths each year in the United States. Drug-resistance in Shigella has been increasing steadily since 2006.

Resistance to traditional first-line drugs such as ampicillin (a penicillin) and trimethoprim-sulfamethoxazole (a folate pathway inhibitor) has become so high that physicians must now rely on alternative drugs like ciprofloxacin (a fluoroquinolone) and azithromycin (a macrolide) to treat infections.

Interactive Graph and Data

Use this graph to view all Shigella isolates or to select S. flexneri or S. sonnei isolates.


Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages]  to view data on the graphs:


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Escherichia coli O157

Most E. coli bacteria are harmless and live in the intestines of people and animals. However some E. coli can cause diarrheal illness or illness outside of the intestinal tract. Shiga toxin-producing E. coli (STEC), which includes E. coli O157, can cause severe disease. An estimated 265,000 STEC infections and 3600 hospitalizations occur each year in the United States.

Antibiotics are not recommended for treating STEC infections but resistant STEC bacteria can transfer their resistance to other types of bacteria. Among E. coli, only serogroup O157 is under surveillance by NARMS. In 2011, about 3% of E. coli O157 isolates were resistant to at least 5 classes of antibiotics.

Interactive Graph and Data

Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages] to view data on the graphs:


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Campylobacter

Campylobacter [PDF - 114 pages] is estimated to cause approximately 1.3 million infections, 13,000 hospitalizations, and 120 deaths each year in the United States. Physicians rely on drugs like ciprofloxacin (a quinolone) and azithromycin (a macrolide) for treating patients with severe disease.

Interactive Graph and Data

This graph includes the option to view C. jejuni or C. coli isolates.

Refer to these tables in the NARMS 2012 Human Isolates Annual Report [PDF - 88 pages]  to view data on the graphs:


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Instructions for using the interactive graphs:

  1. The graphs can be found below in .swf file format. Adobe Flash Player is needed for the graphs to be interactive. Download the free Adobe Flash Player from Adobe's website.
  2. Click on each type of bacteria to view (or hide) the corresponding interactive graph.
  3. For the non-typhoidal Salmonella graph, select All Serotypes Overall, or select any one of the five specific serotypes listed: Enteritidis, Typhimurium, Newport, Heidelberg, or I 4,[5],12:i:-.
  4. For the Campylobacter graph, select C. jejuni or C. coli individually.
  5. For the Shigella graphs, select All Species, or select S. flexnerior S. sonnei.
  6. Click on an antimicrobial class and then on the antimicrobial agent you want to view. Click on the up and down arrows ( and ‚) to view all of the classes.
  7. To view the percentage resistance for a given data point, move your mouse pointer over that data point. Note that resistance <0.05% is shown as 0.0% in the interactive graphs.
  8. Click on the check boxes below the graph to hide (or display) the percentage resistant or the confidence limits.
  9. All graphs are set to auto-scale.  The number of isolates tested each year is displayed in a table below the graph.
  10. Graphs are best viewed with Internet Explorer. Download Internet Explorer at Microsoft's website.
 
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