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Saskia v. Popescu, PhD, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist. During her work as an infection preventionist, she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She holds a doctorate in Biodefense from George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in Infection Control and has worked in both pediatric and adult acute care facilities.

Antibiotic Awareness Week and New National Data From the CDC

NOV 21, 2019 | SASKIA V. POPESCU
Every year in the United States, 2.8 million of these infections occur and 35,000 people die as a result. If you guessed that the disease I’m referring to was influenza, you’d be wrong; I’m talking about antibiotic-resistant infections. This is the latest finding from the 2019 Antibiotic Resistance Threats in the United States by the US Centers for Disease Control and Prevention (CDC). The new data was reported just in time for US Antibiotic Awareness Week, which runs November 18-24th

This particular week is a reminder of the importance of antibiotics, while also recognizing the critical need for stewardship and awareness of resistance. The CDC works with state-based programs, non-profit partners, and many other key stakeholders in raising awareness of both the good antibiotics do, but also the need for proper use.

As the authors of the report note “at least 30% of the antibiotics in US outpatient settings are prescribed unnecessarily. Any time antibiotics are used, they can cause side effects and lead to antibiotic resistance, one of the most urgent threats to the public’s health.”

Over 300 organizations have observed this week of awareness and join in activities from social media (#USAAW19 and #BeAntibioticsAware) to promoting videos available online. Available resources are not only for providers, but also patients and are available in both English and Spanish.

The patient resources are especially helpful for providers as we head into respiratory virus season and many patients request antibiotics for viral infections. The graphics, especially, can be extremely helpful to facilitate conversations with patients on the importance of proper antibiotic stewardship and how they can help stop resistance.  

While many have been making this a priority for years, the new CDC report is a stark reminder of why we must stay vigilant. The finding that there are 2.8 million resistant infections (the last report showed 2 million) each year and 35,000 deaths recorded annually is a red flag that we are truly struggling with this problem.

Each year, they also found that there are 223,900 cases of Clostridioides difficile (at least in 2017), of whom 12,800 died. The report also mentions that prevention efforts have helped reduce deaths by resistant infections by 18% overall and by nearly 30% within hospitals. In fact, there has been a decrease in the number of infections caused by many resistant infections, but as surveillance efforts increase and newly resistant microorganisms proliferate, the overall national burden has grown. Despite the resources to infection prevention and control efforts, this climb in resistant cases is concerning.

The CDC’s report provides not only a national overview of surveillance findings and prevention efforts, but gives us a picture of the true burden of resistant infections. Moreover, it discusses the emerging areas of concern and how these might evolve over the years. Within the report, you can find the estimated infections/deaths since the 2013 report, actions taken, and the gaps that are making progress slow.

The report is also beneficial in that it discusses the 18 antibiotic-resistant bacteria and fungi that are being monitored and breaks them down into 3 categories of concern: urgent, serious, and concerning. Urgent threats include organisms like Candida auris, Carbapenem-resistant Acinetobacter and Enterobacteriaceae, and more. Serious threats include drug-resistant Candida and Campylobacter, Methicillin-resistant Staphylococcus aureus, and drug-resistant tuberculosis among others. 

For this year’s US Antibiotic Awareness Week, perhaps we should take the time to not only read the work the CDC has provided within the 2019 report, but also take the time to evaluate our own practices with antimicrobials and how we can better support stewardship and awareness. How can we individually and collectively work to strengthen awareness and prevent resistance? The truth is that we all have a pivotal role in resistance prevention. What’s yours?
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