As 2019 draws to a close, and we look to 2020, it’s interesting to see how the CDC assesses the risks associated with antibiotic resistance in their updated threat report. The report is well worth a read, providing an overview of the threat of antibiotic resistance, a discussion on the approaches to preventing the emergence and spread of antibiotic resistance, a summary of national action in the US, and an updated list of the threat level from specific pathogens.

The initial section providing an overview of the threat of antibiotic resistance includes updated estimates of the burden of antibiotic resistance in the US. Interestingly, the data shows that the number of deaths related to antibiotic resistance is falling in the US, but the number of people affected is rising, with an estimated 2.8 m antibiotic resistance infections and 35, 000 deaths each year.

The report includes sections on the trends and future prospects in the development of new antibiotics, which are unlikely to be the solution to this complex problem. Instead, we need to improve the prevention of transmission and infection, develop enhanced diagnostics to guide therapy, continue to explore the role of vaccination in preventing antibiotic resistance, and ensure that co-ordinated local, regional, national, and international action is taken.

The CDC has identified five antibiotic resistant bacterial and fungal pathogens that present an urgent threat:

• Carbapenem-resistant Acinetobacter
• Candida auris
• Clostridioides difficile
• Carbapenem-resistant Enterobacteriaceae
• Drug-resistant Neisseria gonorrhoeae

The report includes a detailed and clear summary of the type of threat presented by each pathogen, along with some initiatives that are required to address the threat and minimise the risk. The report also includes lists of serious threat, concerning threat, and watch list pathogens (where the risk is not clear).

Overall, the threat report is visual, helpful, and achieves its purpose of highlighting the serious threat posed by antibiotic resistance to a wide range of audiences (including the public, policy-makers, journalists, and the healthcare professional community).