NCEZID 2017: Antibiotic Resistance

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Containment: Aggressive strategy slows spread of drug-resistant diseases

In May 2017, an Oklahoma hospital identified a patient with an infection from Candida auris, a multidrug-resistant fungus. CDC worked with the Oklahoma State Department of Health and the hospital staff to aggressively search for additional cases to protect other patients and stop its spread. This is one example of CDC’s containment strategy, which CDC rolled out in 2017.

The strategy is a systematic approach aimed at healthcare settings to slow the spread of multidrug-resistant pathogens—beginning with a single case. The strategy is an aggressive response to new and emerging threats, and it focuses on rapidly detecting infections in patients and those who may be silent carriers, determining how the pathogen is being spread, and controlling transmission. Since the containment strategy was used in Oklahoma, the hospital has not found further cases of C. auris infection in its facility. CDC has engaged state health officials about the containment approach and provided hands-on training to state programs nationwide.

The strategy is an aggressive response to new and emerging threats, and it focuses on rapidly detecting resistance.

Public communication: New efforts inform healthcare workers and patients

Public communication is critical to save lives, and in 2017 CDC launched two national efforts to improve patient outcomes and antibiotic use. CDC’s Get Ahead of Sepsis is a new educational initiative that emphasizes the importance of early recognition and timely treatment of sepsis—the body’s extreme and potentially deadly response to an infection—as well as preventing infections that could lead to sepsis. In addition, CDC’s Be Antibiotics Aware: Smart Use, Best Care effort helps healthcare professionals improve antibiotic prescribing and educates patients about when antibiotics should be used. This initiative aims to help ensure antibiotics remain effective when we need them for sepsis and other life-threatening infections. In 2017, CDC engaged more than 500 partners to help promote and launch these two initiatives. CDC hopes that together these national efforts will improve healthcare, decrease health consequences, and ultimately save lives.

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Innovations: CDC pilots projects to combat antibiotic resistance

At least 23,000 people die each year as a direct result of infections with antibiotic resistant bacteria. Preventing antibiotic resistant infections is critical for the health of Americans, and CDC is piloting innovations that will uncover new ways to prevent these infections and stop their spread. CDC supports innovations and research to combat antibiotic resistance and has provided $76.5 million for 84 projects since 2016.

In 2017, CDC supported 25 innovators to explore gaps in knowledge about antibiotic resistance and develop solutions to the antibiotic resistance crises in healthcare, veterinary, and agriculture industries. For example, CDC is working with these innovators to investigate the relationship between antibiotic use during pregnancy and its potential impact on child health.


Prescribing and use: New resource helps rural hospitals address challenges

In the fight against antibiotic resistance, small and critical access hospitals face special challenges. Many of these facilities have limitations in staffing, infrastructure, and resources, which create obstacles when trying to address antibiotic prescribing among doctors and antibiotic use among patients. In 2017, CDC released a new resource to help these hospitals implement programs to improve antibiotic use and prescribing.

To develop a resource that would be tailored to these hospitals and the patients they serve, CDC and partners met with hospital representatives from rural areas to gain a more in-depth understanding of the challenges they face. Implementation of Antimicrobial Stewardship Core Elements at Small and Critical Access Hospitals provides guidance on first steps for starting programs to help these hospitals improve antibiotic prescribing and use, and protect their patients from preventable health consequences like C. difficile infections.