Deadly superbugs pose greater threat than previously estimated
Drug-resistant germs and related infections sicken about 3 million people and kill about 48,000 every year in the United States, according to a new report from the Centers for Disease Control and Prevention. The new estimates show that previous figures missed about half of the illnesses and deaths.
That means, on average, someone in the United States gets an antibiotic-resistant infection about every 10 seconds and someone dies about every 11 minutes.
The long-awaited report, released Wednesday, establishes a new national baseline of infections and deaths from bacteria and fungi that have developed the ability to defeat drugs designed to kill them. Scientists, doctors and public health officials have increasingly warned that antibiotic resistance is one of the gravest public health threats of our time.
The new numbers, though still conservative, underscore the magnitude of the problem and will help prioritize resources to address the most pressing threats, infectious disease experts said. These germs spread through people, animals and the environment.
The report details the toll that 18 pathogens are taking on humans, ranking the threat of each as “urgent,” “serious,” or “concerning.”
Five germs account for the most urgent threats. Three are long-recognized dangers: Clostridioides difficile (C. diff.), drug-resistant gonorrhea, and Carbapenem-resistant Enterobacteriaceae (CRE), also known as “nightmare bacteria” because they pose a triple threat. They are resistant to all or nearly all antibiotics; they kill up to half of patients who get bloodstream infections from them; and the bacteria can transfer their antibiotic resistance to other related bacteria, potentially making the other bacteria untreatable.
Two new ones were added to the urgent category since the CDC’s first report in 2013: a deadly superbug yeast that has alarmed health officials around the world and a family of bacteria that has developed resistance to nearly all antibiotics.
For the first time, the CDC also added a new category to the ones used to classify the 18 pathogens: a watch list of three germs that officials are monitoring because they have the potential to spread resistance widely or are not well-understood in the United States.
Prevention partly successful
Prevention efforts in recent years have reduced the number of infections and deaths in some health-care settings, CDC officials said. Superbug deaths in hospitals decreased by nearly 30% from 2012 to 2017.
But the report cites two worrisome trends: the increasing numbers of resistant infections in the community, including highly drug-resistant gonorrhea, and the growing ability of drug-resistant microbes to share their dangerous resistance genes with other kinds of bacteria, making those other germs untreatable as well.
Antibiotic resistance is particularly deadly for patients in hospitals and nursing homes, and for those with weak immune systems. But these hard-to-treat infections now threaten people undergoing common modern surgeries and therapies, such as knee replacements, organ transplants and cancer treatments.
Helen Boucher, chief of infectious diseases at Tufts University Medical Center, cares for many transplant patients who are vulnerable to these infections.
“But we also see people from everyday life, who are young and otherwise healthy, who get a MRSA infection on their skin,” she said, referring to methicillin-resistant Staphylococcus aureus, which the CDC lists as a serious threat.
If a young and otherwise healthy woman gets a urinary tract infection from another type of bacteria listed as a serious threat, ESBL-enterobacteriaceae, “all we can offer is an intravenous antibiotic for 10 to 14 days” because clinicians no longer have other effective treatments, Boucher said. The intravenous antibiotic can be administered at home. But it requires a catheter to be inserted into a vein, a procedure that also poses an infection risk, she said.
“We want to have diagnostic tools and medical treatments for problems we know we’re going to have,” she said. “But we also need to prepare for the kind of resistance that we could never predict. We know from history that bacteria and mother nature are smarter than we are.”
Resistant bugs
The CDC report estimates that bacterial and fungal infections that are directly resistant to the drugs that once controlled them cause more than 2.8 million infections and 35,000 deaths each year. Another bacterium closely linked to antibiotic use is C. diff., which can thrive when antibiotics kill beneficial bacteria in the digestive system that normally keep it under control, and then can cause deadly diarrhea. When the C. diff illnesses and deaths are added, the annual U.S. toll of all these pathogens is more than 3 million infections and 48,000 deaths.
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