Vancomycin-Resistant Enterococcus
• Of 66,000 Enterococcus infections per year, 20,000 are drug-resistant causing 1,300
deaths.
• Enterococcus strains resistant to vancomycin have few or no treatment options.
Multidrug-Resistant Pseudomonas aeruginosa
• Of 51,000 Pseudomonas infections per year, 6,700 are multidrug-resistant causing 440
deaths.
• 13% of severe healthcare-associated infections caused by Pseudomonas are multidrugresistant,
meaning nearly all or all antibiotics no longer cure these infections.
Drug-Resistant Non-Typhoidal Salmonella (Notifiable to CDC)
• Non-typhoidal Salmonella causes 1.2 million infections per year, of which 100,000 are
drug-resistant resulting in 23,000 hospitalizations and 450 deaths each year.
• Non-typhoidal Salmonella results in more hospitalizations, longer stays, and higher
treatment costs.
Drug-Resistant Salmonella enterica serovar Typhi (Notifiable to CDC)
• Of 21.7 M Salmonella typhi infections worldwide, 5,700 illnesses in the U.S. with 3,800
(67%) of infections are drug-resistant resulting in 620 hospitalizations each year.
• Before the antibiotic era or in areas where antibiotics are unavailable, 20% of Salmonella
typhi infections result in death.
Drug-Resistant Shigella (Notifiable to CDC)
• Shigella causes ~500,000 illnesses, 5,500 hospitalizations, and 40 deaths each year in
the U.S.
• Since 2006, Shigella resistance to traditional first-line antibiotics has become so high
that physicians must now rely on alternative drugs (ciprofloxacin and azithromycin) to
treat infections.
Methicillin-Resistant Staphylococcus aureus (MRSA)
• Over 80,000 invasive MRSA infections and 11,285 related deaths per year (in 2011).
• Severe MRSA infections most commonly occur during or soon after inpatient medical
care.
• Between 2005 and 2001, overall rates of invasive MRSA dropped 31% predominantly
due to appropriate medical procedures implemented in central-line maintenance.
Drug-Resistant Streptococcus pneumoniae (Notifiable to CDC)
• Of 4 million disease incidents and 22,000 deaths, 1.2 M are drug-resistant [to amoxicillin
and azithromycin (Z-Pak)], resulting in 19,000 excess hospitalizations and 7,900 deaths.
• In 30% of S. pneumoniae cases, the bacteria are fully resistant to one or more
antibiotics, causing complications in treatment and death.
• Pneumococcal pneumonia accounts for 72% of all direct medical costs for treatment of
pneumococcal disease and in excess of $96 million in medical costs per year.
• Pneumococcal conjugate vaccine (PCV) prevents disease, reduces antibiotic resistance
by blocking the transmission of resistant S. pneumoniae strains, and protects against 13
strains of S. pneumoniae.
Drug-Resistant Tuberculosis (Notifiable to CDC)
• Tuberculosis (TB) is among the most common infectious diseases and cause of death
worldwide.
• Of 9,588 TB cases in the U.S. in 2013, it is estimated that 1-2% of these cases were
resistant to antibiotics with direct costs for treatment of MDR-TB averaging $134,000 per
case (in 2010 dollars)
• CDC funds health departments in all 50 states, 10 large cities, DC, Puerto Rico, the
Virgin Islands and other territories to conduct surveillance, provide laboratory testing,
perform contact investigations, diagnose cases and provide directly-observed therapy
and medical management for TB cases and therapy for latent TB infection. Five TB
Regional Training and Medical Consultation Centers (RTMCCs) provide training and
medical consultation for these programs.
OF CONCERN Threat Level Pathogens
Vancomycin-Resistant Staphylococcus aureus (Notifiable to CDC)
• Few cases, thus far (13 cases in 4 States since 2002).
• Staph aureus strains resistant to vancomycin have very few or no treatment options.
Erythromycin-Resistant Group A Streptococcus
• Group A Strep (GAS) causes many illnesses, including strep throat (up to 2.6 M cases
per year), toxic shock syndrome, and “flesh-eating” disease (necrotizing fasciitis, 25-35%
fatal).
• Erythromycin-resistant GAS causes 1,300 illnesses and 160 deaths.
• Current concern is the increase in bacteria that show resistance to clindamycin, which
has a unique role in treatment of GAS infections.
Clindamycin-Resistant Group B Streptococcus
• Of 27,000 GBS cases, 7,600 illnesses are drug-resistant, resulting in 440 deaths in the
United States each year.
