Antimicrobial stewardship is crucial to the ongoing viability of existing therapies. To facilitate this stewardship, NHSN allows hospitals to submit data on their antimicrobial usage and receive feedback on how their usage compares to other facilities.1 This feedback can be used by hospital personnel to assess whether their antimicrobial policies are consistent with current best practices. Participation in this program has so far been limited.

Sewerage systems of villages, townships, cities and megacities convey the urine, stool, blood, and sputum of community members, enabling through analysis of community wastewater, a near real-time assessment of population health status and of emerging public health threats. Signature compounds and biomarkers targeted analytically for surveillance may include chemical and biological threat agents, transformation products of the same, human metabolites, biomarkers of exposure and other markers of interest.

Despite decades of attempts to promote judicious AU, the US has high rates of per-person antimicrobial consumption, and extremely high rates of carbapenem use. Such profligate use is a key factor in the high rate of antimicrobial-resistant infections seen in US healthcare facilities. Antimicrobial stewardship (AS) programs have been identified as a critical component of intervention strategies.