A Decade of Action Against AR Infections

Decade of Action Against AR Infections

In the eleventh installment of CDC's AMR Exchange, experts highlighted how over the past decade the Antimicrobial Resistance (AR) Solutions Initiative has strengthened healthcare quality and safety by:

• Preventing healthcare-associated infections.
• Improving appropriate use of antibiotics and antifungals.
• Advancing innovative solutions to address pressing AR challenges.

Discussion highlights

Moderator Stefanie McBride, Associate Director for Policy and Partnerships in CDC's Antimicrobial Resistance Coordination and Strategy Unit, opened the discussion with an overview of the AR Solutions Initiative's investments in national infrastructure to detect, respond to, control, and prevent infections over the past decade.

Gwen Biggerstaff, Deputy Director of the Division of Foodborne, Waterborne, and Environmental Diseases, described how CDC has integrated laboratory, epidemiologic, and partnership systems—through programs such as PulseNet, the National Antimicrobial Resistance Monitoring System (NARMS), FoodNet, and the AR Lab Network—to improve early detection, tracking, and response for drug-resistant enteric and fungal pathogens. The transition to whole genome sequencing and genomic-driven surveillance has increased sensitivity, speed, and resolution for outbreak detection. Gwen emphasized the One Health approach and collaborations across U.S. government agencies and state partners for linking human, animal, food, and environmental data, while noting remaining gaps in diagnostics, awareness, and antifungal treatment options.

Mike Bell, Director of the Division of Healthcare Quality Promotion, discussed how AR threatens the foundational role of antibiotics as a safety net for life-saving medical care, and the U.S. health system as the safety net for every natural disaster and public health threat. He described successes such as the AR Lab Network and the National Healthcare Safety Network that have strengthened surveillance, laboratory capacity, and rapid outbreak response across thousands of healthcare facilities. Mike highlighted the importance of partnerships with state and local partners and noted measurable successes in antibiotic stewardship—guided by CDC's Core Elements of Antibiotic Stewardship and improved health technology—that have reduced overall antibiotic use and unnecessary or incorrect prescriptions, while ensuring that patients who need antibiotics get the right ones before it's too late.

Paige Armstrong, Director of CDC's Global Health Center, explained how CDC's global AR work extends domestic efforts by strengthening surveillance, laboratory, and workforce capacity using the One Health approach in partner countries to detect and control threats at their source. She described leveraging country and regional offices and global networks to translate detection into timely containment. Paige highlighted global gaps in laboratory infrastructure, decentralized diagnostics, data integration, and innovative surveillance (e.g., wastewater and animal health surveillance) and called for partnerships with Ministries of Health and National Public Health Institutes.

Cliff McDonald, Senior Advisor for Microbiome Health in CDC's Division of Healthcare Quality Promotion, summarized CDC investments in AR innovation and applied research that resulted in practical interventions such as pathogen-reduction practices (e.g., chlorhexidine bathing and mupirocin), electronic quality measures, electronic health record (EHR)-integrated clinical decision support, wastewater surveillance, and the CDC–FDA Antimicrobial Resistance Isolate Bank. Cliff highlighted cross-sector collaborations that enabled scaling of these interventions and noted modeling and regional studies demonstrating potential large-scale impact on preventing infections and reducing antibiotic use.

Final thoughts

The panel concluded by underscoring the need to sustain the national infrastructure established by the AR Solutions Initiative so that every community can prevent infections, detect existing and emerging AR threats, and respond rapidly and effectively. Panelists cited technological advances, increased public and professional awareness, improved infection prevention and control practices, and strengthened laboratory workforce capacity as key accomplishments of the AR Solutions Initiative.

Looking ahead

Panelists emphasized that as pathogens continue to adapt, we must do the same. Evolving health-system approaches, adoption of new diagnostics and technologies, integration of microbiome-based strategies, and continued investment to preserve and expand gains in the fight against AR is critical going forward.

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