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Morbidity of infections caused by antimicrobial-resistant bacteria

Karin Travers1, Michael Barza

  • 1Alliance for the Prudent Use of Antibiotics, Boston, MA, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 4, 2002
PubMed

Insights

Antimicrobial resistance in enteric pathogens may increase illness severity and complicate treatment. This resistance, often linked to food animal practices, leads to significantly more diarrhea and hospitalizations in the US.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Antimicrobial resistance (AMR) impacts infection outcomes through altered virulence and treatment response.
  • Enteric pathogens are a significant cause of infectious disease globally.
  • Food animal agriculture is a known contributor to AMR.

Purpose of the Study:

  • To review and synthesize published data on the relationship between antimicrobial resistance and infection outcomes for enteric pathogens.
  • To assess the impact of AMR on disease severity and treatment effectiveness.

Main Methods:

  • Systematic review of published studies examining antimicrobial resistance in enteric pathogens.
  • Analysis of data linking AMR to clinical outcomes such as illness duration and severity.
  • Estimation of excess disease burden (diarrhea, hospitalization) attributable to AMR.

Main Results:

  • Antimicrobial-resistant Salmonella and Campylobacter strains appear more virulent, causing prolonged or severe illness.
  • Some studies suggest poorer outcomes for resistant Campylobacter infections are due to ineffective initial antimicrobial treatment.
  • Fluoroquinolone resistance alone results in over 400,000 excess diarrhea days annually in the US.
  • Antimicrobial resistance contributes to an estimated 8677 excess hospitalization days for nontyphoidal salmonellosis.

Conclusions:

  • Antimicrobial resistance in enteric pathogens is associated with increased disease severity and duration.
  • Ineffective empirical antimicrobial therapy contributes to poorer outcomes in resistant infections.
  • AMR, particularly from food animal sources, imposes a substantial public health burden in the United States through increased morbidity.

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