SHEA calls for more CDC funds after data show 20% hike in resistant hospital infections

Antimicrobial Stewardship
Candida auris

Dr_Microbe / iStock

A fact sheet published by the US Centers for Disease Control and Prevention (CDC) yesterday highlights a 20% rise in hospital-onset infections caused by antimicrobial-resistant pathogens and a fivefold increase in Candida auris infections during the COVID-19 pandemic compared with 2019.

A Society for Healthcare Epidemiology of America (SHEA) statement following the release of the fact sheet calls for continued investment in CDC programs that fight antimicrobial resistance (AMR).

COVID pushed hospitals to 'breaking points'

The CDC fact sheet is a follow-up to its latest AMR report in 2020, which described the rising threat of the AMR pathogens carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Acinetobacter, Candida auris, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), multidrug-resistant (MDR) Pseudomonas aeruginosa, and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales.

The 20% rise in these pathogens from before to during the pandemic peaked in 2021, but in 2022, all pathogens except MRSA remained above prepandemic levels. 

"The increases in antimicrobial resistance (AR) burden seen in 2020 and 2021 are likely due in part to the impact of COVID-19, which pushed healthcare facilities, health departments, and communities near their breaking points," the CDC authors wrote. "This resulted in longer hospital stays for hospitalized patients (including those diagnosed with COVID-19), challenged the implementation of infection prevention and control practices, and increased inappropriate antibiotic use."

With American Rescue Plan Act funding, the CDC supported healthcare and public health professionals' efforts to prevent AMR through programs targeting healthcare-associated infections and AMR, antibiotic stewardship programs, and the CDC’s Antimicrobial Resistance Laboratory Network, the fact sheet said.

The CDC pushed for investment in proven strategies, such as appropriate antibiotic and antifungal use, accurate lab detection, rapid responses, effective infection prevention and control, and innovative prevention strategies.

Beginning in 2025, the CDC will release estimates for 19 or more AMR threats and updates on US AMR threats by pathogen in a new electronic format. "Going forward, CDC will release new estimates for the burden of these threats at least every two years," the authors wrote. "Data are critical to guide efforts to combat AR, and CDC is committed to providing the high-quality data required to steer this important work."

SHEA decries CDC funding cuts

In the SHEA statement, Thomas Talbot III, MD, MPH, president of the SHEA board of trustees, said that continued funding is needed to advance AMR-prevention strategies. "Sufficient funding for effective infection monitoring practices, accurate laboratory detection and rapid response are critical to limiting harmful resistant infections," he said.

Sufficient funding for effective infection monitoring practices, accurate laboratory detection and rapid response are critical to limiting harmful resistant infections.

Thomas Talbot III, MD, MPH

He noted last week's passage of the US House of Representatives Fiscal Year 2025 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill, which cuts funding to the CDC by 20%, eliminates the Agency for Healthcare Research and Quality (AHRQ), and restructures the National Institutes of Health (NIH).

"Enacting these drastic cuts would hinder efforts to combat the advancing threat of antimicrobial resistance," Talbot said. "We strongly urge House members to reverse course and build on the investments made in FY2024 and fund the FY2025 bill at a level that meets the needs of our nation's health." 

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