What to know
Each year in the United States, at least 2 million people in the United States become infected with antibiotic-resistant pathogens. Of those infected, more than 23,000 people die. Scientists use AMD technology to find and identify novel and emerging ways in which antibiotic resistance occurs and spreads.
Addressing antibiotic-resistant pathogens
Antimicrobial resistance occurs when germs are no longer affected by the drugs created to kill them. This means the germs continue to grow and develop resistance.
Antimicrobial resistance has the potential to impact all Americans at every stage of life. In addition, antimicrobial resistance affects the healthcare, veterinary, and agricultural industries. Those two factors make AR one of the world's most urgent public health problems.
Predicting how pathogens will become resistant is a challenge. However, AMD technologies help CDC scientists study existing and emerging antibiotic-resistant organisms.
These organisms include some of the biggest threats, like Clostridioides difficile (C. diff) and carbapenem-resistant Enterobacteriaceae (CRE). Other antibiotic-resistant organisms being addressed by AMD technologies include Mycobacterium tuberculosis, Neisseria gonorrhoeae, and the fungus Candida auris.
By using AMD technologies in antibiotic resistance surveillance, scientists can look more deeply at these germs. These technologies help healthcare providers select the most effective medications to treat infections.
Discovering a dangerous fungus in U.S. hospitals
In 2016, CDC alerted U.S. hospitals and clinicians to be on the lookout for a dangerous multidrug-resistant fungus, Candida auris. Shortly thereafter, CDC scientists detected C. auris infections in patient samples shared from laboratories around the nation.
Furthermore, AMD technology revealed C. auris strains were closely related to each other. That information also helped investigators understand how the fungus was spreading in healthcare settings.
With the help of AMD technology, CDC scientists are discovering which antifungal medications are most effective against C. auris. CDC scientists also track how the fungus spreads in healthcare facilities. AMD plays a role in helping CDC scientists devise ways to detect, control, and stop the spread of this potentially deadly pathogen.
Preventing healthcare-associated infections
Healthcare facilities are working to protect their patients from healthcare-associated infections (HAIs) and to prevent their spread. These HAIs include infections caused by antibiotic-resistant organisms, in particular, the bacteria called carbapenem-resistant Enterobacteriaceae (CRE). CRE is referred to as the “nightmare bacteria” because it kills almost half of all people who get infected. It usually infects patients in healthcare settings and has become resistant to nearly all the antibiotics we have today.
These bacteria can also spread their resistance to other bacterial species. CDC scientists use AMD technologies to study CRE's genetic material, along with other bacteria.
The overarching goal is to better understand how these bacteria spread and to understand how the bacteria share resistance. Improving the ability to detect and identify the characteristics of these bacteria helps to determine how best to stop their spread. It also provides insights into how to help healthcare facilities prevent infections.
Did you know?
Tracking and stopping resistance genes
A new gene known as mcr -1 can make bacteria resistant to colistin, a last-resort drug for some multidrug-resistant infections. The mcr-1 gene, hitches a ride on a plasmid, which is a small piece of DNA able to move from one bacterium to another. If the gene spreads to a second bacteria, that bacteria will be resistant to colistin.
AMD technology has been particularly enlightening in outbreaks where resistance genes are carried on plasmids. Those outbreaks may involve multiple species of bacteria and are difficult to decipher using conventional laboratory methods.
As a result, CDC now recognizes two types of HAI outbreaks. The first is the classic outbreak, in which the infections are caused by a single pathogen. The second is a newly recognized type of outbreak caused by a plasmid spreading antibiotic resistance across multiple pathogens.