More than 2 million infections per year are caused by antimicrobial resistant organisms in the United States alone. Without preventative actions, antimicrobial resistant infections will become the leading cause of death worldwide in 2050, outpacing death caused by all cancers.
Antimicrobials are drugs that treat infections caused by fungi, bacteria, or viruses. Antimicrobials have played a major role in the advancement of medicine and have extended the human lifespan.
Antibiotics are drugs that only treat bacterial infections. Antibiotics kill bacteria by altering normal bacterial cell processes. Bacteria have the capability to become resistant to all available antibiotics.
Learn More about Antimicrobial Resistance
The human body is home to trillions of bacteria, viruses and fungi cells. These cells can live on the skin or in the gut. Microorganisms provide a necessary function for human survival.
As the bacteria replicate they can undergo mutations. Sometimes, these mutations help them fight off antibiotics that would normally be effective. Antimicrobial use has contributed to the development of mutations causing resistance.
The resistant organisms proliferate overtime, becoming the predominant organism type. Sometimes, the resistant organisms pass along the instructions to other organisms, causing more widespread resistance.
- The 2019 AR Threats Report indicates that more than 2.8 million AR infections occur in the U.S. each year, and more than 35,000 people die each year as a result. Additionally, in the U.S., Clostridioides difficile infection caused nearly 223,900 hospitalizations and 12,800 deaths.
- A total of 18 AR bacteria and fungi are classified into one of three categories: urgent, serious, and concerning.
- The 2019 AR Threats Report outlines what has been done and where we need to address gaps in the fight against AR.
- Please visit the CDC’s 2019 AR Threats Report page to read the full report.
MDROs are defined as organisms resistant to at least one or more classes of antimicrobial agents. MDROs present significant risk to patients because of their limited therapeutic options for the infections they cause.
Common MDROs include:
- Candida kruseii
- Carbapenem resistant gram-negative organisms, such as Carbapenem resistant Enterobacteriaceae or Carbapenem resistant Pseudomonas
- Extended spectrum β-lactamase (ESBLs) producing Gram-negative bacteria
- Methicillin Resistant Staphylococcus aureus (MRSA)
- Vancomycin Resistant Enterococci (VRE)
Less Common MDROs with the potential to spread include:
- Candida auris
- Carbapenemase producing gram-negative bacteria
- Vancomycin resistant Staphylococcus aureus
Decreasing antimicrobial resistance requires antimicrobial stewardship and infection prevention efforts. Antimicrobial Stewardship Programs (ASP) reduce antimicrobial resistance by optimizing antimicrobial therapy. ASPs should exist for every practice setting. Programs should be in accordance with the CDC Core Elements for Antimicrobial Stewardship recommendations. More information can be found on the VDH Antimicrobial Stewardship Webpage. Infection prevention is a cornerstone for decreasing the transmission of MDROs. More information can be found on the VDH Infection Prevention Webpage.
Virginia State and Regional Cumulative Antibiogram
Facility-level antibiograms provide a summary of the percentage of isolates susceptible to a variety of antimicrobial agents within a healthcare facility. They are an important tool for the development of antimicrobial stewardship policies and protocols for empiric antibiotic selection. Some facilities, however - such as small hospitals, skilled nursing facilities and physician practices - do not have enough isolates to create a facility-level antibiogram. These facilities would benefit from a regional and state wide antibiogram to help guide antibiotic selection.
The Virginia Healthcare-Associated Infections Advisory Group, led by the Virginia Department of Health, Health Quality Innovators, and the Virginia Hospital and Healthcare Association, addressed this gap in resources by analyzing data from facility-level antibiograms to create a regional and state-wide antibiogram.
In addition to the benefit to small facilities, the antibiogram also gives an understanding of antimicrobial susceptibility and resistance among bacteria recovered from clinical specimens across Virginia. This allows public health professionals to evaluate temporal trends and geographic patterns to guide infection prevention and antimicrobial stewardship efforts.
CDC’s Antimicrobial Resistance Laboratory Network (AR Lab Network), established in 2016, provides nationwide lab capacity to rapidly detect antimicrobial resistance and inform local responses to prevent spread and protect people. It closes the gap between local capabilities and the data needed to combat antimicrobial resistance in the U.S.
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