Current Antibiotic Threats in the U.S.


CRE (carbapenem-resistant Enterobacteriaceae)
CRE, carbapenem-resistant Enterobacteriaceae, are the “nightmare bacteria” we reported on in March. These include bacteria that can resist all antibiotics, kill a high number of people who get it in their blood, and spread their resistance capabilities to other bacteria.

CDC – Making Health Care Safer

Threat 1

Clostridium difficile
C.difficile, a life-threatening infection causing deadly diarrhea, causes at least 250,000 hospitalizations and 14,000 deaths each year. Although not significantly resistant itself, C. difficile infections usually happen to people who are taking or who recently took antibiotics, or who caught the infection from those who did.

Threat 2

Drug-resistant Neisseria gonorrhoeae
Thirty percent of gonorrhea infections are caused by microbes resistant to at least one antibiotic. If gonorrhea becomes resistant to antibiotics called cephalosporins, there could be an estimated 75,000 additional cases of pelvic inflammatory disease, a major cause of infertility. I’ve taken care of patients with infected joints from gonorrhea which has spread – a complication that can be disabling, painful, and expensive to treat.

Threat 3

Multidrug-resistant Acinetobacter
Acinetobacter is a type of gram-negative bacteria that is a cause of pneumonia or bloodstream infections among critically ill patients. Many of these bacteria have become very resistant to antibiotics.

Threat 4

Drug-resistant Campylobacter
Campylobacter usually causes diarrhea (often bloody), fever, and abdominal cramps, and sometimes causes serious complications such as temporary paralysis.

Threat 5

Fluconazole-resistant Candida
Candidiasis is a fungal infection causes by yeasts of the genus Candida. Candida is the fourth most common cause of healthcare-associated bloodstream infections in the United States. In some hospitals it is the most common causes. These infections tend to occur in the sickest patients.

Threat 6

Extended spectrum β-lactamase producing Enterobacteriaceae
Extended-spectrum β-lactamase is an enzyme that allows bacteria to become resistant to a wide variety of penicillins and cephalosporins. Bacteria that contain this enzyme are known as ESBLs or ESBLproducing bacteria. ESBL-producing Enterobacteriaceae are resistant to strong antibiotics including extended spectrum cephalosporins.

Threat 7

Vancomycin-resistant Enterococcus
Enterococci cause a range of illnesses, mostly among patients receiving healthcare, but include bloodstream infections, surgical site infections, and urinary tract infections.

Threat 8

Multi-drug resistant Psedomonas Aeruginosa
Pseudomonas aeruginosa is a common cause of healthcare-associated infections including pneumonia, bloodstream infections, urinary tract infections, and surgical site infections.

Threat 9

Drug-resistant non-typhoidial Salmonella
Non-typhoidal Salmonella (serotypes other than Typhi, Paratyphi A, Paratyphi B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and abdominal cramps. Some infections spread to the blood and can have life-threatening complications.

Threat 10

Drug-resistant Salmonella Serotype Typhi
Salmonella serotype Typhi causes typhoid fever, a potentially life-threatening disease. People with typhoid fever usually have a high fever, abdominal pain, and headache. Typhoid fever can lead to bowel perforation, shock, and death.

Threat 11

Drug-resistant Shigella
Shigella usually causes diarrhea (sometimes bloody), fever, and abdominal pain. Sometimes it causes serious complications such as reactive arthritis. High-risk groups include young children, people with inadequate handwashing and hygiene habits, and men who have sex with men.

Threat 12

Methicillin-resistant Staphylococcus aureus
Methicillin-resistant Staphylococcus aureus (MRSA) causes a range of illnesses, from skin and wound infections to pneumonia and bloodstream infections that can cause sepsis and death. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.

Threat 13

Drug-resistant Streptococcus pneumoniae
Streptococcus pneumoniae (S. pneumoniae, or pneumococcus) is the leading cause of bacterial pneumonia and meningitis in the United States. It is also a major cause of bloodstream infections and ear and sinus infections.

Threat 14

Drug-resistant Tuberculosis
Tuberculosis (TB) is among the most common infectious diseases and a frequent cause of death worldwide. TB is caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis) and is spread most commonly through the air. M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. In most cases, TB is treatable and curable with the available first-line TB drugs; however, in some cases, M. tuberculosis can be resistant to one or more of the drugs used to treat it. Drug-resistant TB is more challenging to treat — it can be complex and requires more time and more expensive drugs that often have more side effects. Extensively Drug-Resistant TB (XDR TB) is resistant to most TB drugs; therefore, patients are left with treatment options that are much less effective. The major factors driving TB drug resistance are incomplete or wrong treatment, short drug supply, and lack of new drugs. In the United States most drug-resistant TB is found among persons born outside of the country.

Threat 15

Vancomycin-resistant Staphylococcus aureus
Staphylococcus aureus is a common type of bacteria that is found on the skin. During medical procedures when patients require catheters or ventilators or undergo surgical procedures, Staphylococcus aureus can enter the body and cause infections. When Staphylococcus aureus becomes resistant to vancomycin, there are few treatment options available because vancomycin-resistant S. aureus bacteria identified to date were also resistant to methicillin and other classes of antibiotics.

Threat 16

Erythromycin-resistant Group A Streptococcus
Group A Streptococcus (GAS) causes many illnesses, including pharyngitis (strep throat), streptococcal toxic shock syndrome, necrotizing fasciitis (“flesh-eating” disease), scarlet fever, rheumatic fever, and skin infections such as impetigo.

Threat 17

Clindamycin-resistant Group B Streptococcus
Group B Streptococcus (GBS) is a type of bacteria that can cause severe illnesses in people of all ages, ranging from bloodstream infections (sepsis) and pneumonia to meningitis and skin infections.

Threat 18



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