Antibiotic Resistance Threats in the United States, 2013 report
Antibiotic Resistance Threats in the United States, 2013 report
Antibiotic Resistance Threats in the United States, 2013 report
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Technical Appendix<br />
Drug-Resistant Non-Typhoidal Salmonella<br />
Methods<br />
Estimates of <strong>the</strong> number of illnesses and deaths from <strong>in</strong>fections with<br />
non-typhoidal Salmonella resistant to ceftriaxone, resistant or partially<br />
resistant to ciprofloxac<strong>in</strong>, or resistant to five or more antibiotic classes<br />
are <strong>report</strong>ed. They were derived by multiply<strong>in</strong>g an estimate of <strong>the</strong><br />
annual number of non-typhoidal Salmonella illnesses or deaths <strong>in</strong> <strong>the</strong><br />
<strong>United</strong> <strong>States</strong> 1 by <strong>the</strong> average prevalence of resistance among non-typhoidal Salmonella<br />
isolates tested by <strong>the</strong> National Antimicrobial <strong>Resistance</strong> Monitor<strong>in</strong>g System (NARMS) dur<strong>in</strong>g<br />
<strong>the</strong> years 2009–2011. <strong>Resistance</strong> breakpo<strong>in</strong>ts from <strong>the</strong> NARMS 2011 Human Isolates Report<br />
were used. 3 For ciprofloxac<strong>in</strong>, isolates with <strong>in</strong>termediate susceptibility results (m<strong>in</strong>imum<br />
<strong>in</strong>hibitory concentration of 0.12–0.5 µg/ml) were considered partially resistant.<br />
Many assumptions were made <strong>in</strong> deriv<strong>in</strong>g <strong>the</strong> estimates. The estimated number of illnesses<br />
from resistant Salmonella was divided by <strong>the</strong> U.S. population and multiplied by 100,000<br />
to calculate <strong>the</strong> estimated number of illnesses from resistant Salmonella per 100,000<br />
population. The U.S. population <strong>in</strong> 2006 (approximately 299 million people) was used for<br />
<strong>the</strong> calculations because <strong>the</strong> estimated number of non-typhoidal Salmonella illnesses <strong>in</strong><br />
<strong>the</strong> <strong>United</strong> <strong>States</strong> was based on this population. 1 The methods used to estimate <strong>the</strong> direct<br />
medical costs for Salmonella <strong>in</strong>fections were previously <strong>report</strong>ed. 2<br />
References<br />
1 Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired <strong>in</strong> <strong>the</strong> <strong>United</strong><br />
<strong>States</strong>—major pathogens. Emerg Infect Dis. 2011;17:7–15.<br />
2 CDC. National Antimicrobial <strong>Resistance</strong> Monitor<strong>in</strong>g System for Enteric Bacteria<br />
(NARMS): Human Isolates F<strong>in</strong>al Report, 2011. Atlanta, Georgia: U.S. Department of<br />
Health and Human Services, CDC, <strong>2013</strong>.<br />
3 CDC. Vital Signs: Incidence and Trends of Infection with Pathogens Transmitted<br />
Commonly Through Food—Foodborne Diseases Active Surveillance Network, 10 U.S.<br />
Sites, 1996–2010. MMWR 2011;60:749–55.<br />
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