Key points
- CDC's Antibiotic Resistance Threats in the United States, 2019 (2019 AR Threats Report) includes national death and infection estimates for 18 antimicrobial-resistant bacteria and fungi.
- CDC lists germs in three categories—urgent, serious and concerning—and a watch list.
- This report underscores the continued threat of antimicrobial resistance in the U.S., the actions taken to combat this threat and gaps slowing progress.
Overview
CDC's 2019 AR Threats Report includes national death and infection estimates that underscore the continued threat of AR in the United States.
The germs are listed in three categories—urgent, serious and concerning—based on level of concern to human health. The report also includes a Watch List with three threats that have not spread widely in the U.S. but could become common without continued aggressive action.
The 2019 AR Threats Report is intended to:
- Serve as a reference for information on AR.
- Provide the latest AR burden estimates for human health in the U.S.
- Highlight emerging areas of concern and additional action needed.
The 2019 report also emphasizes progress in combating AR. However, CDC's 2022 special report highlighting the impact of COVID-19 on antimicrobial resistance in the U.S. found that much of that progress was lost, in large part, due to the effects of the pandemic. The pandemic pushed healthcare facilities, health departments and communities near their breaking points in 2020, making it very hard to maintain the progress in combating AR. Thankfully, the 2022 National and State Healthcare-Associated Infections Progress Report shows that the U.S. is gaining ground lost during the first years of the COVID-19 pandemic with decreases in standardized infection rates for some HAIs, including a 16% decrease in hospital-onset methicillin-resistant Staphylococcus aureus and a 3% decrease in hospital onset Clostridioides difficile. As evident from the pandemic, without continued action and vigilance these gains will only be temporary.
About antimicrobial-resistant infections
About the first AR Threats Report
In 2013, CDC published the first AR Threats Report, which sounded the alarm to the danger of AR. The 2013 and 2019 reports do not include viruses (e.g., HIV, influenza) or parasites. The 2013 report stated that each year in the U.S. at least 2 million people got an antimicrobial-resistant infection, and at least 23,000 people died. The 2013 AR Threats Report helped inform the first National Action Plan for Combating Antibiotic-Resistant Bacteria.
Bacteria and fungi listed in the 2019 AR Threats Report
Urgent threats
Carbapenem-resistant Acinetobacter
Clostridioides difficile (C. difficile)
Carbapenem-resistant Enterobacteriaceae (CRE)
Drug-Resistant Neisseria Gonorrhoeae
Serious threats
Drug-Resistant Candida Species
Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae
Vanomycin-Resistant Enterococci (VRE)
Multidrug-Resistant Pseudomonas Aeruginosa
Drug-Resistant Non-Typhoidal Salmonella
Drug-Resistant Salmonella Serotype Typhi
Methicillin-Resistant Staphylococcus Aureus (MRSA)
Drug-Resistant Streptococcus pneumoniae
Drug-Resistant Tuberculosis (TB)
Concerning threats
Erythromycin-Resistant Group A Streptococcus
Clindamycin-Resistant Group B Streptococcus
Watch list
Antimicrobial-Resistant Aspergillus
Take action
Addressing the threat of AR worldwide requires:
- Preventing infections in the first place.
- Slowing the development of resistance through appropriate capacity and resources like infection prevention.
- Access to antibiotics and antifungals, diagnostic testing and vaccines.
CDC is working with partners to strengthen prevention efforts and improve antibiotic and antifungal use so that the world benefits.
We all have a role to play, from travelers, animal owners, and care givers to patients and healthcare providers. Let's take action.
- Protect Yourself and Your Family | CDC
- Healthcare Providers: Actions to Combat Resistance | CDC
- Health Departments: Actions to Combat Resistance | CDC
- Veterinarians: Actions to Combat Resistance | CDC
- Livestock and Poultry Producers: Actions to Combat Resistance | CDC
What CDC is doing
CDC leads the U.S. public health response to combat AR. CDC's AR Solutions Initiative has heavily invested in domestic capacity to detect, respond, contain, and prevent the spread of resistance across health care, food, environment, and communities. This includes sounding the alarm, and providing the data for action, technical expertise, and support for a domestic infrastructure to respond to AR. To accomplish this work, CDC successfully collaborates with partners across health care, industry, academia, and government.
The world needs heightened vigilance and public health engagement to contain resistance threats whenever and wherever they emerge. Swift public health action is fundamental to save lives.
Resources
- 2022 Special Report: COVID-19 U.S. Impact on AR [PDF –44 pages]
- 2019 AR Threats Report [PDF – 150 pages]
- Free print copy on CDC-INFO on Demand (Pub ID 300754)
- November 2019 press release
- Pathogen Illustrations
- 2013 AR Threats Report [PDF - 114 pages]
- Latest News and Resources: Antibiotic Resistance | CDC