The Centers for Disease Control and Prevention (CDC) estimates that at least 2 million illnesses and 23,000 deaths are caused annually by antibiotic-resistant bacteria in the United States alone.1 The BBC reported that, in Europe and the United States, 50,000 deaths each year are attributable to antimicrobial resistance and that, unless action is taken, deaths will rise more than 10-fold by 2050. Also by 2050, more than one in four deaths in Nigeria will be caused by drug-resistant infections, and India will lose an additional 2 million lives each year, the BBC said.2
On September 18, 2014, President Barack Obama issued an Executive Order affirming the US government's commitment to establishing “a strategic, coordinated, and sustained effort” for detecting, preventing, and controlling antibiotic resistance: “The Federal Government will work domestically and internationally to detect, prevent, and control illness and death related to antibiotic-resistant infections by implementing measures that reduce the emergence and spread of antibiotic-resistant bacteria and help ensure the continued availability of effective therapeutics for the treatment of bacterial infections.”3
To support the White House's National Strategy for Combating Antibiotic-Resistant Bacteria,4 the CDC formed the Detect and Protect Against Antibiotic Resistance Initiative (known as the AR Initiative) to focus its efforts on four areas:
- Slow the development of resistant bacteria and prevent the spread of resistant infections
- Strengthen national “one-health” surveillance efforts to combat resistance. A one-health approach “promotes the integration of public health and veterinary disease, food, and environmental surveillance. Improved detection can be achieved through appropriate data sharing, enhancement, expansion, and coordination of existing surveillance systems.”4
- Advance the development and use of rapid and innovative diagnostic tests for the identification and characterization of resistant bacteria
- Improve international collaboration and capacities for antibiotic resistance prevention, surveillance, and control and antibiotic research and development
The AR Initiative is part of the CDC's strategy to target investment at antibiotic resistance. The 2015 President's Budget requests $30 million in annual funding for 5 years for the AR Initiative to achieve measurable results for detecting and tracking patterns of antibiotic resistance, responding to outbreaks, preventing infections from occurring and resistant bacteria from spreading, and supporting the National Institutes of Health (NIH) and private industry in their discovery efforts.5
According to the CDC,5 a $30 million annual funding level over 5 years could achieve
- a 50% reduction in health-care-associated Clostridium difficile
- a 50% reduction in health-care-associated carbapenem-resistant Enterobacteriaceae infections
- a 30% reduction in health care-associated multidrug-resistant Pseudomonas, a common cause of health care-associated infections
- a 30% reduction in invasive methicillin-resistant Staphylococcus aureus
- a 25% reduction in multidrug-resistant Salmonella infections
The goal of the CDC's AR Initiative is to improve detection through the creation of a new regional laboratory network and resistant bacteria bank. It also seeks to prevent infection and improve antibiotic prescribing practices in health care facilities and in
the community. n
1. Centers for Disease Control and Prevention. National strategy to combat antibiotic-resistant bacteria. http://www.cdc.gov/drugresistance/national-strategy/index.html. Accessed February 11, 2015.
2. Walsh F. Superbugs to kill ‘more than cancer' by 2050. http://www.bbc.com/news/health-30416844. Accessed January 15, 2015.
3. The White House. Executive Order: Combating Antibiotic-Resistant Bacteria. http://www.whitehouse.gov/the-press-office/2014/09/18/executive-order-combating-antibiotic-resistant-bacteria. Accessed February 11, 2015.
4. National Strategy for Combating Antibiotic Resistant Bacteria. http://www.whitehouse.gov/sites/default/files/docs/carb_
national_strategy.pdf. Accessed February 11, 2015.
5. Centers for Disease Control and Prevention. Detect and protect against antibiotic resistance. http://www.cdc.gov/drugresistance/pdf/AR_Initiative_Fact_Sheet.pdf. Accessed February 11, 2015.