I 
113TH CONGRESS 
1ST SESSION H. R. 2285 
To amend the Public Health Service Act to enhance efforts to address 
antimicrobial resistance, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 6, 2013 
Mr. MATHESON introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to enhance efforts 
to address antimicrobial resistance, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Strategies to Address 
Antimicrobial Resistance Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) The advent of the antibiotic era has saved 
millions of lives and allowed for incredible medical 
progress; however, the increased use and overuse of 
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antimicrobial drugs have correlated with increased 
rates of antimicrobial resistance. 
(2) Through mutation as well as other mecha-
nisms, bacteria and other infectious disease-causing 
organisms—viruses, fungi, and parasites—develop 
resistance to antimicrobial drugs over time. The 
more antimicrobial drugs are used, whether appro-
priately or inappropriately, the more this contributes 
to the development of antimicrobial resistance. 
(3) Scientific evidence suggests that the devel-
opment of antimicrobial resistance in humans is not 
due only to use of antimicrobial drugs in humans, 
but also may be caused by the use of antimicrobial 
drugs in food-producing animals. 
(4) A study estimates that in 2005 more than 
94,000 invasive methicillin-resistant Staphylococcus 
aureus (MRSA) bacterial infections occurred in the 
United States and more than 18,500 of these infec-
tions resulted in death—7 times more than a decade 
earlier. 
(5) The 2009 Influenza A: H1N1 virus out-
break, and the yearly seasonal influenza outbreaks, 
exacerbate concerns about antiviral resistance given 
that so few antivirals are available to treat influenza 
as well as secondary bacterial infections due to 
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MRSA, 
antibiotic-resistant 
Streptococcus 
pneu-
monia, and other bacteria that cause respiratory dis-
eases. Given that, during the 1918 influenza pan-
demic, many thousands of deaths were caused by 
complications due to secondary bacterial infections 
and not by the influenza virus itself. 
(6) Each year, nearly 2,000,000 people contract 
bacterial infections in hospitals and approximately 
90,000 of these people die from these infections. 
Many of these infections are resistant to one or 
more commonly used antibiotics. 
(7) A 2012 study conducted at Columbia Uni-
versity (‘‘Clinical Infectious Disease’’, September 
2012) found that each antibiotic-resistant infection 
cost, on average, over $15,000 more to treat than 
susceptible infections. 
(8) The costs of antimicrobial-resistant infec-
tions in terms of lives lost and the economy will only 
rise as antimicrobial resistance continues to spread. 
SEC. 3. ANTIMICROBIAL RESISTANCE TASK FORCE. 
Section 319E of the Public Health Service Act (42 
U.S.C. 247d–5) is amended— 
(1) in subsection (a)— 
(A) in the subsection heading, by striking 
‘‘TASK FORCE’’ and inserting the following: 
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‘‘ANTIMICROBIAL RESISTANCE OFFICE, TASK 
FORCE, AND ADVISORY BOARD’’; 
(B) in paragraph (1)— 
(i) by striking ‘‘as of the date of the 
enactment of this section’’ and inserting 
‘‘as of September 30, 2006’’; and 
(ii) by adding at the end the fol-
lowing: ‘‘The Secretary shall, not later 
than 1 year after the date of enactment of 
the Strategies to Address Antimicrobial 
Resistance Act, direct the Assistant Sec-
retary of Health to establish an Anti-
microbial Resistance Office and appoint a 
director to that Office. The Secretary shall, 
not later than 1 year after the date of en-
actment of such Act, establish the Public 
Health Antimicrobial Advisory Board as an 
advisory board to the Director of the Anti-
microbial Resistance Office. The Director 
of the Antimicrobial Resistance Office shall 
serve as the Director of the Antimicrobial 
Resistance Task Force. To avoid duplica-
tion and ensure that Federal resources are 
used efficiently and effectively, the Direc-
tor shall work in conjunction with the Fed-
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eral agencies represented on the Task 
Force to coordinate all antimicrobial resist-
ance activities undertaken and supported 
by the Federal Government, including the 
activities and budgetary allocations of the 
Office, Task Force, and Public Health 
Antimicrobial Advisory Board.’’; 
(C) by amending paragraph (2) to read as 
follows: 
‘‘(2) MEMBERS.— 
‘‘(A) MEMBERS
OF
THE
ANTIMICROBIAL 
RESISTANCE TASK FORCE.—The task force de-
scribed in paragraph (1) shall be composed of 
representatives of such Federal agencies as the 
Secretary determines necessary, including rep-
resentation of the following: 
‘‘(i) The Antimicrobial Resistance Of-
fice. 
‘‘(ii) The Assistant Secretary for Pre-
paredness and Response. 
‘‘(iii) The Biomedical Advanced Re-
search and Development Authority. 
‘‘(iv) The Centers for Disease Control 
and Prevention. 
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‘‘(v) The Food and Drug Administra-
tion. 
‘‘(vi) The National Institutes of 
Health. 
‘‘(vii) The Agency for Healthcare Re-
search and Quality. 
‘‘(viii) The Centers for Medicare & 
Medicaid Services. 
‘‘(ix) The Health Resources and Serv-
ices Administration. 
‘‘(x) The Department of Agriculture. 
‘‘(xi) The Department of Education. 
‘‘(xii) The Department of Defense. 
‘‘(xiii) The Department of Veterans 
Affairs. 
‘‘(xiv) The Environmental Protection 
Agency. 
‘‘(xv) The Department of Homeland 
Security. 
‘‘(xvi) The United States Agency for 
International Development. 
‘‘(B) MEMBERS OF THE PUBLIC HEALTH 
ANTIMICROBIAL ADVISORY BOARD.— 
‘‘(i) IN GENERAL.—The Public Health 
Antimicrobial Advisory Board shall be 
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composed of 19 voting members, appointed 
by the Secretary. Such members shall in-
clude experts from the medical professions 
(including hospital and community-based 
physicians), pharmacy, public health, vet-
erinary, research, and international health 
communities, as well as one representative 
from a public interest group. 
‘‘(ii) 
TERMS.—Each 
member 
ap-
pointed under clause (i) shall be appointed 
for a term of 3 years, except that of the 
19 members first appointed— 
‘‘(I) 6 shall be appointed for a 
term of 12 months; and 
‘‘(II) 6 shall be appointed for a 
term of 2 years. 
‘‘(iii) CHAIR.—The Secretary shall ap-
point a Chair of the Public Health Anti-
microbial Advisory Board from among its 
members to lead and supervise the activi-
ties of the Advisory Board. 
‘‘(iv) DISCLOSURE OF FINANCIAL IN-
TERESTS.—Prior to a meeting of the Pub-
lic Health Antimicrobial Advisory Board, 
each member of the Advisory Board shall 
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disclose to the Secretary any potential, rel-
evant financial interests as defined under 
section 208(a) of title 18, United States 
Code.’’; 
(D) in paragraph (3)(B), by striking ‘‘in 
consultation with the task force described in 
paragraph (1) and’’ and inserting ‘‘acting 
through the Director of the Antimicrobial Re-
sistance Office and the Director of the Centers 
for Disease Control and Prevention, and in con-
sultation with’’; and 
(E) by amending paragraph (4) to read as 
follows: 
‘‘(4) MEETINGS AND DUTIES.— 
‘‘(A) ANTIMICROBIAL RESISTANCE OFFICE 
DUTIES.—The Director of the Antimicrobial 
Resistance Office, working in conjunction with 
the Federal agencies that are represented on 
the task force described in paragraph (1), shall 
issue an update to the Public Health Action 
Plan to Combat Antimicrobial Resistance within 
1 year of the establishment of the Office and 
annually thereafter. The updates shall include 
enhanced plans for addressing antimicrobial re-
sistance in the United States and internation-
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ally. The Director of the Office shall post on a 
website these updates as well as summaries of 
all non-proprietary data the Task Force makes 
available. The Director of the Antimicrobial Re-
sistance Office shall work in conjunction with 
the Federal agencies that are represented on 
the task force described in paragraph (1), and 
in consultation with the Public Health Anti-
microbial Advisory Board, to— 
‘‘(i) establish benchmarks for achiev-
ing the goals set forth in the action plan; 
‘‘(ii) assess the ongoing, observed pat-
terns of emergence of antimicrobial resist-
ance, and their impact on clinical outcomes 
in terms of how patients feel, function, or 
survive; 
‘‘(iii) assess how antimicrobial prod-
ucts are being used in humans, animals, 
plants, and the environment and the risks 
and benefits of those uses in furthering the 
development of resistance and the implica-
tions thereof for patient safety and public 
health; 
‘‘(iv) establish a priority list of human 
infectious diseases with the greatest need 
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for development of new point-of-care and 
other diagnostics, antimicrobial drugs, and 
vaccines, and in particular serious and life- 
threatening resistant infections, for which 
there are few or no diagnostic, treatment, 
or prevention options; 
‘‘(v) recommend basic, clinical, epide-
miological, prevention, and translational 
research where additional federally sup-
ported studies may be beneficial; 
‘‘(vi) recommend how to support anti-
microbial development through Food and 
Drug Administration activities, including 
through the agency’s Critical Path Initia-
tive and the Reagan-Udall Foundation; 
‘‘(vii) 
recommend 
how 
best 
to 
strengthen and link antimicrobial resist-
ance-related surveillance and prevention 
and control activities; and 
‘‘(viii) collaborate with the Assistant 
Secretary for Preparedness and Response 
to ensure that strategies to address anti-
microbial-resistance are coordinated with 
initiatives aimed at pandemic influenza, se-
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vere acute respiratory syndrome, and bio-
terrorism. 
‘‘(B) ANTIMICROBIAL
RESISTANCE
TASK 
FORCE MEETINGS AND DUTIES.— 
‘‘(i) MEETINGS.—The Antimicrobial 
Resistance Task Force shall convene peri-
odically as the Director of the Anti-
microbial Resistance Task Force deter-
mines to be appropriate, but not fewer 
than twice a year, to consider issues relat-
ing to antimicrobial resistance. 
‘‘(ii) 
PUBLIC
HEALTH
ACTION 
PLAN.—At least twice a year, the task 
force described in paragraph (1) shall have 
a meeting to review, discuss, and further 
develop the Public Health Action Plan to 
Combat 
Antimicrobial 
Resistance 
first 
issued by the interagency task force on 
antimicrobial resistance in 2001. Among 
other issues, the task force may discuss 
and review, based on current need or con-
cern— 
‘‘(I) antimicrobial clinical suscep-
tibility concentrations proposed, estab-
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lished, or updated by the Food and 
Drug Administration; 
‘‘(II) data obtained by govern-
ment agencies and, as possible, by pri-
vate 
sources 
on 
emerging 
anti-
microbial resistance related to clinical 
outcomes as well as data related to 
how antimicrobial drugs may have 
been used inappropriately; 
‘‘(III) surveillance data and pre-
vention and control activities regard-
ing emerging antimicrobial resistance 
from reliable sources including the 
Centers for Disease Control and Pre-
vention, the Food and Drug Adminis-
tration, the Department of Defense, 
the Department of Veterans Affairs, 
the Department of Agriculture, the 
Environmental 
Protection 
Agency, 
and as feasible from private sources 
and international bodies; 
‘‘(IV) data on the amount of 
antimicrobial products used in hu-
mans, animals, plants, and the envi-
ronment from reliable sources, includ-
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ing data from the Centers for Disease 
Control and Prevention, the Food and 
Drug Administration, the Environ-
mental Protection Agency, the De-
partment of Veterans Affairs, the 
Centers for Medicare & Medicaid 
Services, the Department of Home-
land Security, and the Department of 
Agriculture, and as feasible from pri-
vate sources and international bodies; 
‘‘(V) the impact of antimicrobial 
resistance on human health resulting 
from the approval of antimicrobial 
drugs for use in humans, animals, or 
plants (including consideration of and 
recommendations on potential man-
agement plans to limit and reduce the 
negative impacts of such resistance on 
human health and consideration of 
the benefits to animal health and food 
safety); 
‘‘(VI) reports of federally sup-
ported antimicrobial resistance re-
search and antimicrobial drug, related 
diagnostics, and vaccine development 
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for antimicrobial resistant infections 
(such as methicillin-resistant Staphy-
lococcus aureus (MRSA)) and other 
research activities (including clinical, 
epidemiological, prevention, and trans-
lational research) obtained from Fed-
eral agencies, as well as reports of re-
search sponsored by other countries, 
industry, and non-governmental orga-
nizations; 
‘‘(VII) reports on efforts by the 
Food and Drug Administration to de-
velop policies and guidance which en-
courage antimicrobial drug, related 
diagnostics, and vaccine development 
and appropriate use while maintaining 
high standards for safety and effec-
tiveness; 
‘‘(VIII) quality measures, which 
may include health plan employer 
data and information set (HEDIS) 
measures, pertaining to appropriate 
use of antimicrobial drugs; and 
‘‘(IX) other data and issues the 
task force described in paragraph (1) 
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identifies as relevant to the issue of 
antimicrobial resistance. 
‘‘(iii) PENDING
APPLICATIONS.—The 
Food and Drug Administration may con-
sult with the Director of the Antimicrobial 
Resistance Office concerning the pending 
application of any antimicrobial drug appli-
cation submitted to the Secretary under 
section 505 or 512 of the Federal Food, 
Drug, and Cosmetic Act or the Public 
Health Service Act. 
‘‘(C) PUBLIC HEALTH ANTIMICROBIAL AD-
VISORY BOARD MEETINGS AND DUTIES.— 
‘‘(i) MEETINGS.—The Public Health 
Antimicrobial Advisory Board shall meet 
as the Chair of the Public Health Anti-
microbial Advisory Board determines to be 
appropriate, preferably in conjunction with 
meetings of the Antimicrobial Resistance 
Task Force, but not fewer than 2 times 
each year. 
‘‘(ii) RECOMMENDATIONS.—The Pub-
lic Health Antimicrobial Advisory Board 
shall make recommendations to the Sec-
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retary, and the Antimicrobial Resistance 
Office, regarding— 
‘‘(I) ways to encourage the avail-
ability of an adequate supply of safe 
and effective antimicrobial products, 
related diagnostics, and vaccines; 
‘‘(II) 
research 
priorities 
and 
other measures (such as antimicrobial 
drug resistance management plans) to 
enhance the safety and efficacy of 
antimicrobial products; 
‘‘(III) how best to implement and 
update the goals of the Public Health 
Action Plan to Combat Antimicrobial 
Resistance; 
‘‘(IV) incentives necessary to es-
tablish uniform mechanisms (which 
could include electronic surveillance 
systems) and data sets for State and 
local reporting of resistance; 
‘‘(V) the adequacy of existing 
United States antimicrobial resistance 
and use surveillance; 
‘‘(VI) the development of a na-
tional plan for the collection and anal-
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ysis of isolates of resistant pathogens, 
including establishing priorities as to 
which isolates should be collected; and 
‘‘(VII) areas for government, 
nongovernment, and international co-
operation to strengthen implementa-
tion of the Public Health Action Plan 
to Combat Antimicrobial Resistance. 
‘‘(D) AVAILABILITY
OF
INFORMATION.— 
The Antimicrobial Resistance Office shall en-
sure that all information shall be made avail-
able to the public on the website described in 
subparagraph (A) consistent with section 9 of 
the Strategies to Address Antimicrobial Resist-
ance Act.’’; 
(2) by amending subsection (b) to read as fol-
lows: 
‘‘(b) ANTIMICROBIAL RESISTANCE STRATEGIC RE-
SEARCH PLAN.—The Secretary, acting through the Direc-
tor of the National Institutes of Health, working in con-
sultation with the Director of the Centers for Disease Con-
trol and Prevention, the Assistant Secretary for Prepared-
ness and Response, the Director of the Biomedical Ad-
vanced Research and Development Authority, the Director 
of the Antimicrobial Resistance Office, the Public Health 
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Antimicrobial Advisory Board, and other non-government 
experts, including representatives from professional soci-
eties and the pharmaceutical, vaccine, and medical device 
industries, and other Federal agencies shall develop a 
blue-ribbon antimicrobial resistance strategic research 
plan that strengthens existing epidemiological, inter-
ventional, clinical, behavioral, translational, and basic re-
search efforts to advance the understanding of— 
‘‘(1) the development, implementation, and effi-
cacy of interventions to prevent and control the 
emergence and transmission of antimicrobial resist-
ance; 
‘‘(2) how best to optimize antimicrobial effec-
tiveness while limiting the emergence of resistance, 
including addressing issues related to duration of 
therapy, effectiveness of therapy in self-resolving dis-
eases, and determining populations most likely to 
benefit from antimicrobial drugs; 
‘‘(3) the extent to which specific uses of anti-
microbial products in humans, animals, plants, and 
other uses accelerates development and transmission 
of antimicrobial resistance; 
‘‘(4) the natural histories of infectious diseases 
(including defining the disease, diagnosis, severity, 
and the time course of illness); 
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‘‘(5) the development of new therapeutics, in-
cluding antimicrobial drugs, biologics, and devices 
against resistant pathogens, and in particular dis-
eases for which few or no therapeutics are in devel-
opment; 
‘‘(6) the development and testing of medical 
diagnostics to identify patients with infectious dis-
ease and identify the exact cause of infectious dis-
eases syndromes, particularly with respect to the de-
tection of pathogens resistant to antimicrobial drugs; 
‘‘(7) the epidemiology, pathogenesis, mecha-
nisms, and genetics of antimicrobial resistance; and 
‘‘(8) the sequencing of the genomes, or other 
DNA analysis, or other comparative analysis of pri-
ority pathogens (as determined by the Public Health 
Antimicrobial Advisory Board), in collaboration with 
the Department of Defense and the Joint Genome 
Institute of the Department of Energy.’’; 
(3) in subsection (c)— 
(A) by inserting ‘‘acting through the Di-
rector of the Antimicrobial Resistance Office,’’ 
after ‘‘The Secretary,’’; and 
(B) by striking ‘‘members of the task force 
described in subsection (a),’’; 
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(4) in subsection (d)(1), by inserting ‘‘, through 
the Antimicrobial Resistance Office,’’ after ‘‘The 
Secretary’’; 
(5) in subsection (e)— 
(A) by amending the subsection heading to 
read as follows: ‘‘IMPROVING UPTAKE
AND 
MEASUREMENT OF ANTIMICROBIAL STEWARD-
SHIP’’; 
(B) in paragraph (1)— 
(i) by inserting ‘‘, acting through the 
Director of the Antimicrobial Resistance 
Office,’’ after ‘‘The Secretary’’; and 
(ii) by striking ‘‘judicious use of anti-
microbial drugs or control the spread of 
antimicrobial-resistant pathogens’’ and in-
serting ‘‘the uptake and measurement of 
antimicrobial stewardship programs in the 
Nation’s health care facilities’’; 
(C) in paragraph (2), by striking ‘‘labora-
tory’’; 
(D) in paragraph (3), by inserting ‘‘, act-
ing through the Antimicrobial Resistance Of-
fice,’’ after ‘‘The Secretary’’; and 
(E) by adding at the end the following new 
paragraphs: 
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‘‘(4) DEFINITION OF ANTIMICROBIAL STEWARD-
SHIP.—For purposes of this subsection and Act, 
‘antimicrobial stewardship’ means coordinated inter-
ventions designed to improve and measure the ap-
propriate use of antimicrobial agents, including pro-
moting the use of antimicrobials only when clinically 
indicated, and, when antimicrobials are indicated, 
promoting the selection of the optimal antimicrobial 
drug regimen including dosing, duration of therapy, 
and route of administration. 
‘‘(5) PREFERENCE
IN
MAKING
AWARDS.—In 
making awards under paragraph (1), the Secretary 
shall give preference to eligible entities that will use 
grant funds to establish demonstration projects that 
lead to the development of quality measures for 
health care providers prescribing antimicrobial 
drugs.’’; 
(6) by redesignating subsections (f) and (g) as 
subsections (i) and (j), respectively; and 
(7) by inserting after subsection (e) the fol-
lowing new subsections: 
‘‘(f) APPROPRIATE ANTIMICROBIAL USE.—The Sec-
retary, acting through the Director of the Centers for Dis-
ease Control and Prevention, shall take such additional ac-
tions as follows: 
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‘‘(1) To pilot and test health care quality meas-
ures to help providers, facilities, and health systems 
measure and benchmark appropriate antimicrobial 
use. As appropriate, the Director shall work with 
standard setting organizations (such as the National 
Quality Forum, the Joint Commission, and the Na-
tional Committee for Quality Assurance) to deter-
mine if any such measure is suitable for national 
quality reporting efforts. 
‘‘(2) To develop methods to help providers, fa-
cilities, and health systems measure and improve ap-
propriate antimicrobial use, including methods and 
tools to assess the change in antimicrobial use, the 
impact on antibiotic resistance and adverse effects 
(such as Clostridium difficile infections), and the 
economic impact and cost savings of antimicrobial 
stewardship programs. 
‘‘(g) COLLECTION OF HUMAN ANTIMICROBIAL CON-
SUMPTION AND RESISTANCE TREND DATA.— 
‘‘(1) ANTIMICROBIAL USE DATA.—The Director 
of the Centers for Disease Control and Prevention 
shall work with private vendors, health care organi-
zations, pharmacy benefit managers, and other enti-
ties to obtain reliable and comparable human anti-
microbial drug consumption data (including volume 
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antimicrobial distribution data and antimicrobial 
use, including prescription data) by State or metro-
politan area. 
‘‘(2) 
ANTIMICROBIAL
RESISTANCE
TREND 
DATA.—The Director of the Centers for Disease 
Control and Prevention shall intensify and expand 
their efforts to collect antimicrobial resistance data 
including through the establishment of an Anti-
microbial Resistance Surveillance and Laboratory 
Network, established in section 4 of the Strategies 
to Address Antimicrobial Resistance Act, and devel-
opment of a fully automated antimicrobial resistance 
and use module within the National Healthcare 
Safety Network. The Director shall seek to collect 
data from electronic medication administration re-
ports (eMAR) and laboratory systems to produce 
regular reports on antimicrobial resistance patterns 
and antimicrobial use. 
‘‘(3) MEANINGFUL USE REPORTING.—The Of-
fice of the National Coordinator for Health Informa-
tion Technology shall work with the Director of the 
Centers for Disease Control and Prevention to deter-
mine how best antimicrobial use, susceptibility, and 
resistance data can be incorporated into meaningful 
use reporting. 
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‘‘(4) REPORT.—Not later than 2 years after the 
date of the enactment of the Strategies to Address 
Antimicrobial Resistance Act, and every two years 
thereafter, the Director of the Centers for Disease 
Control and Prevention shall submit to the Com-
mittee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Edu-
cation, Labor and Pensions of the Senate and make 
available on the agency’s website a report summa-
rizing key trends and major issues related to anti-
microbial resistance and use in the United States. 
Each such report shall include the most relevant and 
up-to-date data available from the infectious diseases 
and surveillance programs of the Centers for Disease 
Control and Prevention. Each such report shall— 
‘‘(A) outline major issues and threats in 
antimicrobial resistance facing the United 
States; 
‘‘(B) provide data on the incidence, preva-
lence, morbidity, mortality, and general societal 
burden, including economic, of antimicrobial re-
sistant pathogens; 
‘‘(C) provide updates on resistance pat-
terns and antimicrobials use data and potential 
impacts on human health and patient safety; 
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‘‘(D) articulate activities of the Centers for 
Disease Control and Prevention targeted toward 
measuring and preventing the spread of drug 
resistant pathogens; 
‘‘(E) describe any international develop-
ments that may impact antimicrobial resistance 
in the United States; and 
‘‘(F) identify the major gaps that the Na-
tion faces in the areas of antimicrobial resist-
ance surveillance, prevention, use, and anti-
microbial stewardship. 
‘‘(h) ENSURE ACCESS TO ANTIMICROBIAL RESIST-
ANCE DATA AND RESEARCH.—The Director of the Anti-
microbial Resistance Office shall work with the Federal 
agencies represented on the Antimicrobial Resistance 
Task Force to identify relevant data and formats, and 
mechanisms for communicating such data to the Anti-
microbial Resistance Office and Antimicrobial Resistance 
Task Force and, in a manner consistent with section 9 
of the Strategies to Address Antimicrobial Resistance Act, 
with the Public Health Antimicrobial Advisory Board and 
the public, including relevant data obtained by the agen-
cies through contracts with other organizations, includ-
ing— 
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‘‘(1) use and clinical outcomes data on patients 
receiving antimicrobial drugs for the treatment, pre-
vention, or diagnosis of infection or infectious dis-
eases; 
‘‘(2) surveillance data regarding emerging anti-
microbial drug resistance and existing resistance 
patterns; 
‘‘(3) susceptibility data related to antimicrobial 
drug use; 
‘‘(4) data related to the amount of anti-
microbial products used in humans, animals, plants, 
and the environment; 
‘‘(5) data from federally funded research in-
tended to support antimicrobial drug, vaccine, and 
related diagnostics development; 
‘‘(6) data demonstrating the impact of research, 
surveillance, and prevention and control initiatives in 
understanding and controlling antimicrobial resist-
ance; and 
‘‘(7) data regarding implementation and evalua-
tion of interventions to improve antimicrobial drug 
prescribing practices.’’. 
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SEC. 4. ANTIMICROBIAL RESISTANCE SURVEILLANCE AND 
LABORATORY NETWORK. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Cen-
ters for Disease Control, shall establish at least 10 Anti-
microbial Resistance Surveillance and Laboratory Net-
work sites, building upon the intramural and extramural 
programs and laboratories of the Centers for Disease Con-
trol and Prevention, to intensify, strengthen, and expand 
the national capacity to— 
(1) monitor the emergence and changes in the 
patterns of antimicrobial resistant pathogens; 
(2) describe, confirm, and as necessary facili-
tate a response to local or regional outbreaks of re-
sistant pathogens; 
(3) assess and describe antimicrobial resistance 
patterns to inform public health and improve preven-
tion practices; 
(4) obtain isolates of pathogens, and in par-
ticular, pathogens that show new or atypical pat-
terns of resistance adversely affecting public health; 
(5) study the epidemiology of infections from 
such pathogens; 
(6) evaluate commonly used antimicrobial sus-
ceptibility testing methods to improve the accuracy 
of resistance testing and reporting; and 
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(7) as necessary, develop novel diagnostic tests 
capable of detecting new or emerging resistance in 
pathogens. 
(b) GEOGRAPHIC DISTRIBUTION.—The sites estab-
lished under subsection (a) shall be geographically distrib-
uted across the United States. 
(c) NONDUPLICATION OF CURRENT NATIONAL CA-
PACITY.—The sites established under subsection (a) may 
be based in academic centers, health departments, and ex-
isting surveillance and laboratory sites. 
SEC. 5. CLINICAL TRIALS NETWORK ON ANTIBACTERIAL 
RESISTANCE. 
(a) IN GENERAL.—The Secretary, acting through the 
Director of the National Institute of Allergy and Infec-
tious Diseases, shall establish a Clinical Trials Network 
on Antibacterial Resistance to enhance, strengthen, and 
expand research on clinical science, antibacterial and diag-
nostic development, and optimal usage strategies, and 
shall, at a minimum— 
(1) facilitate research to better understand re-
sistance mechanisms and how to prevent, control, 
and treat resistant organisms; 
(2) advance clinical trial efforts to develop anti-
microbial therapies, vaccines and diagnostics, and 
evaluate and optimize their usage; 
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(3) conduct clinical research to develop natural 
histories of resistant infectious diseases; 
(4) examine patient outcomes with currently 
available antimicrobial therapy and validate and im-
prove upon biomarkers and other surrogate end-
points; and 
(5) study shorter treatment duration and early 
cessation of antimicrobial therapy for treatment effi-
cacy and effect on development of resistance. 
(b) LEADERSHIP GROUP FOR A CLINICAL RESEARCH 
NETWORK ON ANTIBACTERIAL RESISTANCE.—The Sec-
retary, acting through the Director of the National Insti-
tute of Allergy and Infectious Diseases, shall establish a 
Leadership Group for the Clinical Research Network on 
Antibacterial Resistance described in subsection (a) to de-
velop and implement a comprehensive clinical research 
agenda to address antibacterial resistance that takes into 
consideration the recommendations contained in the Stra-
tegic Research Plan on Antimicrobial Resistance devel-
oped in accordance with section 319E of the Public Health 
Service Act. The Leadership Group shall provide support 
for the following components— 
(1) scientific leadership and operations; 
(2) network laboratories; and 
(3) statistical and data management. 
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(c) APPROPRIATIONS.—There are authorized to be 
appropriated from the existing budget of the National In-
stitute of Allergy and Infectious Diseases, $100,000,000 
annually for each of fiscal years 2014 through 2020 to 
carry out this section. 
SEC. 6. REGIONAL PREVENTION COLLABORATIVES. 
The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention, shall work 
with State health departments to support regional preven-
tion collaboratives designed to interrupt and prevent the 
transmission of significant antibiotic resistant pathogens 
being transmitted across health care settings in a geo-
graphic region. Such regional prevention collaboratives 
shall work to— 
(1) identify significant drug resistant pathogens 
being transmitted across health care settings locally; 
(2) implement evidence-based interventions to 
interrupt and prevent the transmission of such 
pathogens; and 
(3) evaluate the impact of such measures on 
hospital readmissions, transitions of care, rates of 
health care associated infections, or any other rel-
evant measures that characterize the health or eco-
nomic impact of the collaboratives. 
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