Federal Panel Passes Antibiotic-Resistant Bacteria Resolutions

Troy Brown, RN

March 02, 2018

The Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria's (PACCARB's) Immediate Action Subcommittee unanimously passed two resolutions to maintain programs dealing with antibiotic-resistant bacterial infections and maintain or increase funding for such efforts at a March 2 teleconference.

"As with other biological threats posing national security, health, and economic concerns, the danger posed by antibiotic-resistant bacterial infections is high, but carries an even greater probability for future harm with far-reaching, short- and long-term, domestic and international implications," Martin J. Blaser, MD, PACCARB chair, and Lonnie J. King, DVM, MS, MPA, ACVPM, PACCARB vice chair, write in the first resolution.

Morbidity and mortality associated with such infections is widespread in the United States and increasing. Therefore, federal efforts to address these infections must be included as part of the all-hazards approach of the US Department of Health and Human Services in protecting our nation and in legislation to be maintained as a priority, according to the first resolution.

Executive Order 13676 included the establishment of PACCARB in 2014. The group, which includes experts in veterinary medicine, infectious diseases, geographic medicine, microbiology, and economics, has produced two authoritative reports since 2015. PACCARB utilizes a One Health approach, which recognizes the connection between the health of people and the health of animals and the environment.

"[T]he current federal efforts that are using One Health approaches to fight antibiotic-resistance are at risk of being undermined by significant loss or redirection of funding," Drs Blaser and King explain.

"Although initiated through executive order, we unanimously recommend that the PACCARB be codified into law to sustain the One Health partnerships formed and continue its mission to produce reports and recommendations that influence federal CARB-related activities, both domestic and abroad," Drs Blaser and King write.

Funding for Programs in Danger

The second resolution seeks to maintain or increase funding for programs that address antibiotic resistance in humans and animals. It calls for maintaining or increasing funding for the Centers for Disease Control and Prevention's (CDC's) Antibiotic Resistance Solutions Initiative (ARSI) and for the Agency for Healthcare Research and Quality's (AHRQ's) healthcare-associated infection and antibiotic-resistance (HAI/AR) programs during 2018 and beyond. The CDC's ARSI is in danger of losing much of its $163 million fiscal year 2017 appropriation during 2018, and AHRQ may suffer a significant budget cut as well.

"In the past decade, we have seen encouraging early declines in occurrences of antibiotic-resistant bacterial infections in hospitals, largely as a result of programs initiated by the CDC and AHRQ. These programs have led to much lower rates of device-related (eg, intravenous catheter) and other healthcare-associated infections (eg, [methicillin-resistant Staphylococcus aureus (MRSA)] bloodstream infections). All of these gains will be lost if the critical mission funding for the CDC and AHRQ HAI/AR programs is not maintained," Drs Blaser and King write in the second resolution.

The National Action Plan on Combating Antibiotic Resistant Bacteria focuses on the health of both humans and animals; the CDC has included infections that are typically food-borne (including Campylobacter, Salmonella, and Shigella ) on its list of the biggest drug-resistant threats in the United States. The US Department of Agriculture's National Institute of Food and Agriculture has dedicated funding to support research "on antibiotic resistance in agriculture from farm to fork" and this funding must continue, Dr King said during the teleconference.

"There's new momentum; last year was a real bellwether year for action, especially in the animal health side, but we are still concerned about the future financial support for human health, for animal health, and for environmental health, and concerned about not only maintaining or increasing these funds but making sure they're not redirected to other areas away from [antimicrobial resistance]," Dr King explained.

The group's next meeting is tentatively scheduled for May 16-17, 2018.

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