23,000 Die Yearly of Antibiotic Resistant Infections

Antibiotic resistance is a rapidly progressing, extremely dangerous problem that affects everyone. In a recent Centers for Disease Control and Prevention (CDC) report, chronicled below in a CDC release, the agency detailed for the first time the toll that antibiotic-resistant microbes are taking on humans. Infections resulting from antibiotic resistance, such as methicillin-resistant Staphylococcus (MRSA), have been on the media forefront for well over a decade, but in this report the CDC takes a truly comprehensive look at over two dozen lesser known bacterial infections, ranking the threat of each as “urgent,” “serious” or “concerning.”

On the CDC’s “urgent” list are carbapenem-resistant Enterobacteriaceae (CRE), Neisseria gonorrhoeae, and Clostridium difficile.

Drug-resistant gonorrhea is the second most commonly reported notifiable infection in the U.S., responsible for some 800,000 cases a year, 246,000 of which are drug-resistant. There is grave concern that the easily sexually transmitted infection might become resistant to cephalosporins, especially ceftriaxone (Rocephin), the mainstay of first-line treatment. The CDC projects that progressive cephalosporin resistance would, over the next 10 years, result in 75,000 additional cases of pelvic inflammatory disease, 15,000 cases of epididymitis, and 222 additional HIV infections, as well as extra direct medical costs of $235 million.

In itself, the third organism on the “urgent” list, C. difficile, is not resistant to most antimicrobials used to treat it, but is definitely regarded as an unintended consequence of overuse of antibiotics. Although not included in the estimated 23,000 deaths associated with antibiotic resistance, the severe diarrhea and metabolic disturbance associated with C. difficile leads to approximately 14,000 deaths in U.S. hospitals annually.

Michael Jacobs, MD, of University Hospitals Case Medical Center in Cleveland told MedPage Today that red flags have been going up for years about antibiotic resistance. “The CDC report is a landmark because it’s the first really comprehensive look at the issue nationwide.” He points out that the problem has been growing for decades, and the new report is unlikely to make an immediate and sharp change. “Nothing is going to make a dramatic difference,” he said. “It’s going to be a long, slow struggle.

So, the CDC’s core action #3: “…The commitment to always use antibiotics appropriately and safely – only when they are needed to treat disease – and to choose the right antibiotics and to administer them in the right way in every case,” is the most important action needed to greatly slow the development and spread of antibiotic-resistant infections. Antibiotic stewardship, as it’s called, requires an enlightened, integrated and disciplined effort on the part of physicians, patients, pharmacists and healthcare policy makers.

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Eric Write head editor and chief at The Pluto Daily