On July 16, 2024, the CDC published new data concerning the prevalence of seven key antimicrobial-resistant pathogens in healthcare settings. The report highlights a notable increase in infections linked to the COVID-19 pandemic, which strained healthcare systems and led to longer hospital stays, disrupted infection control practices, and increased inappropriate antibiotic usage. This resulted in a peak in antimicrobial resistance (AR) during 2021, followed by a decline due to aggressive public health interventions. Comparative data indicate a 20% rise in hospital-onset infections from six bacterial pathogens during the pandemic, with rates remaining elevated into 2022.1
In response to the CDC's new findings, Thomas R Talbot, III, MD, MPH, FSHEA, president of the SHEA Board of Trustees, discussed with Contagion SHEA's proactive efforts to ensure ongoing funding for CDC programs aimed at combating AR.
“SHEA is appealing directly to House and Senate appropriators to fund the CDC at a sustainable level. We've conducted several member visits with members of the House and Senate appropriations committees to educate them on the value of these programs and convey what will be lost should they not be funded at a level that will sustain operations.”
Key programs include:
- National Healthcare Safety Network (NHSN)
- AR Solutions Initiative
- Advanced Molecular Detection Program
SHEA's Advocacy Efforts
The AR Solutions Initiative, requiring $400 million annually under the CDC’s NCEZID, is crucial. It aims to expand antibiotic stewardship, double state and local grants, strengthen the AR Laboratory Network for pathogen containment, support AMR research and epicenters, and enhance public and healthcare professional education.2
According to SHEA’s advocacy for the AR Solutions Initiative “AR infections arise when the bacteria causing an infection in a patient no longer responds to available antibiotics. Such infections lead to severe illness or death. AR is one of the most serious and urgent global public health threats of our time. The federal government must invest in a long-term global strategy that supports infrastructure, new technology, and innovative research.”2
Main Takeaways
- SHEA is actively advocating for sustained funding from House and Senate appropriators to support critical CDC programs such as the NHSN and the AR Solutions Initiative, crucial for combating AR.
- The AR Solutions Initiative aims to bolster antibiotic stewardship, strengthen pathogen containment efforts, and enhance education and research to address severe global public health threats posed by AR.
- The COVID-19 pandemic significantly exacerbated AR infections, highlighting the need for enhanced strategies and continued support for CDC programs like NHSN to effectively track and manage healthcare-associated infections.
The report from SHEA emphasizes the most serious multidrug HAI threats we are facing today are:
- Carbapenem-resistant Enterobacterales: a category of bacteria that causes a series of infections to develop resistance to the group of antibiotics called carbapenems.
- Acinetobacter: cause infections in the blood, urinary tract, and lungs (pneumonia), or in wounds in other parts of the body.
- Candida auris: a type of yeast that can cause infections in different parts of the body such as in the bloodstream, open wounds, and ears.
- C difficile: causes diarrhea and colitis and occurs during or shortly after patients take antibiotics.2
The COVID-19 pandemic significantly increased rates of AR infections due to several contributing factors. In preparation for future challenges, healthcare systems must identify and address these factors with improved strategies.
“We suspect that a myriad of factors drove this increase, from the acuity of the COVID-19-infected patients to the impact that the surges had on healthcare personnel’s ability to follow standard infection prevention practices (eg, hand hygiene, use of isolation precautions and environmental cleaning) to the impact on antibiotic stewardship and increased utilization of antibiotics,” according to Talbot.
The CDC's NHSN is crucial for tracking healthcare-associated infections nationwide. It provides essential data to facilities, states, and regions, helping to identify areas needing improvement. This data helps identify areas needing improvement, assess the effectiveness of prevention strategies, and work towards eradicating healthcare-associated infections.3
Talbot emphasizes, “CDC's NHSN is an essential tool in our surveillance and outbreak detection system. It is currently undergoing modernization supported by one-time investments from the American Rescue Plan and the Data Modernization Initiative. Once completed, the NHSN will have more automation capabilities and provide more granular, real-time data to detect threats and provide a faster, more targeted response. The recently released threat report shows that we need to ensure that funding for CDC programs is predictable and sustainable so that we do not risk losing momentum in our efforts to combat AR infections. Congress must ensure that the CDC's topline and line-item funding levels for NHSN are enough to support the newly modernized program.”
The forthcoming updates to the CDC's AR threat reporting will shape future public health strategies and funding decisions to combat these infections effectively.
Talbot concludes, “Failure to adequately fund the CDC at the topline level will put pressure and risk of failure on a programmatic level, even if some lines are flat-funded. SHEA will continue to highlight the value and positive impact of these CDC programs on the clinical and research efforts of the healthcare epidemiology, infection prevention, and antibiotic stewardship communities.”
References
CDC. National Healthcare Safety Network (NHSN). Last reviewed April 30, 2024. Accessed July 24, 2024. https://www.cdc.gov/nhsn/index.html
