Three Antimicrobial Resistance Trends We Saw in 2019

By the bioMérieux Connection Editors

In the first half of the year, the prevalence of Candida auris infections took the public by surprise, even though infections had been occurring for years around the world.  In November, the CDC released its 2019 AR Threat Report, which added two more microbes to the list of Urgent Threats. And, a poll from the Kaiser Family Foundation suggested that antibiotic resistance awareness efforts are beginning to pay off. Read on for more about each of these trends in antimicrobial resistance for 2019.

1. Deadly Candida auris (C. auris) infections sprang into the public consciousness when the New York Times released an extensive article in April.

C. auris infections have become increasingly common in healthcare facilities around the world, though they received little public attention until the New York Times published its report.  While antibiotic resistance awareness has improved (more on that later), people may not realize that microbes other than bacteria can also become resistant to treatment—any microbe can, whether it is a bacteria, virus, fungus, or parasite.

Scientists and physicians have long been concerned about broader antimicrobial resistance, and in 2018, Dr. Matthew C. Fisher and colleagues published a paper in the journal Science, entitled, Worldwide emergence of resistance to antifungal drugs challenges human health and food security. However, broad public recognition of the problem did not occur at the time.

While C. auris typically infects people who are already immunocompromised or who have other serious medical conditions, the CDC has listed it as an Urgent Threat because of its high mortality rate and difficulty with treatment and identification. You can read more about C. auris infections here.

2. Drug-resistant Candida auris and Carbapenem-resistant Acinetobacter emerged as new Urgent Threats in the CDC’s 2019 AR Threat Report.

The CDC released its first AR Threat Report in 2013, a major step in bringing awareness to the problem of antimicrobial resistance.  Five years later, in November 2019, the CDC released its second report, supported by even more extensive data and highlighting the rise of new resistant infections.

Candida auris and Carbapenem-resistant Acinetobacter were added to the CDC’s updated Urgent Threat list, joining Clostridiodes difficile, Carbapenem-resistant Enterobacteriaceae, and drug-resistant Neisseria gonorrheae. Urgent Threats are, “germs [that] are public health threats that require urgent and aggressive action,” according to the CDC.

Carbapenem-resistant Acinetobacter infections occur most often in patients who have recently received care at a medical facility. The bacteria can cause pneumonia, wound infections, bloodstream infections, and urinary tract infections.  Resistant Acinetobacter infections occurred frequently in the Middle East, causing complications for wounded soldiers. You can read more about Acinetobacter and Carbapenem resistance here.

3. Public awareness of antibiotic resistance in the United States has risen, but many patients don’t understand their role in reducing risk.

A Kaiser Family Foundation poll released in June suggested that a strong majority of American public is aware that antibiotic resistance is a problem.  71% of respondents had heard the term “antibiotic resistance,” and know the meaning. When ranked against other major health threats, 72% said they were worried about antibiotic resistance (the poll had a margin of error of plus or minus 3%).

While most people knew about the consequences of antibiotic overuse, including the need to use stronger and more expensive drugs to treat infections, a third of respondents did not know or did not believe overuse could lead to those consequences. Additionally, the poll indicated that there is still a lot of confusion about what antibiotics can and cannot treat. Although 75% of respondents knew that antibiotics treat bacterial infections, 55% either erroneously thought that viral infections could be treated with antibiotics, or they weren’t sure.  47% specifically thought that flu could be treated with antibiotics, or they weren’t sure.

Another issue that the poll highlighted was that only 30% of people thought that patients could play a role in reducing antibiotic resistance.  Paired with results that showed 45% haven’t taken antibiotics as prescribed (39% did not finish a course of antibiotics, and 16% took them without consulting a healthcare professional), it’s clear that we need further educational efforts to address the gaps in understanding and to change behaviors. You can read more about antibiotic and antimicrobial resistance here.

The Fight Against Antimicrobial Resistance is Ongoing

Microbes, like all living organisms, will continue to evolve over time, which means that antimicrobial resistance will always be a threat. 2019 showed that antimicrobial resistance has the spotlight—now we must work together to stay ahead of the challenge.

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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