The U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms.
And the news is not good. In fact it’s downright scary. The agency’s overall conservative assessment of the problem includes frightening statistics such as:
- Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics
- Each year, out of those illnesses, there are 23,000 deaths
- Each year, those illnesses and deaths result in $20 billion of additional healthcare spending
- Each year, an additional $35 billion lost to society in foregone productivity.
The report marks the first time the agency has provided hard numbers for the incidence, deaths and cost of all the major resistant organisms. It also represents the first time the CDC has ranked resistant organisms by how much and how imminent a threat they pose, using seven criteria:
- health impact
- economic impact
- how common the infection is
- how easily it spreads
- how much further it might spread in the next 10 years
- whether there are antibiotics that still work against it
- whether things other than administering antibiotics can be done to curb its spread
Out of that matrix, their top three “urgent” threats they identified were:
- Carbapenem-resistant Enterobacteriaceae (CRE), a family of ICU germs that includes Klebsiella and E. coli, that have become are resistant to almost all antibiotics, resulting in 9,000 infections per year and at least 600 deaths
- Antibiotic-resistant gonorrhea, which currently responds to only one drug: 246,000 infections per year
- Clostridium difficile, which causes 250,000 illnesses, 14,000 deaths.
In addition, the CDC identified 12 resistant bacteria and fungal infections which the agency dubs “serious” i.e., requiring “prompt and sustained action.” They include the hospital-acquired infections Acinetobacter, Pseudomonas aeruginosa, and Vancomycin-Resistant Enterococcus (VRE) ; the foodborne organisms Campylobacter, Salmonella and Shigella; MRSA; Candida and TB.
The last category, “concerning” i.e., requiring “careful monitoring and prevention” includes rare but potent vancomycin-resistant staphylococcus aureus (VRSA), as well as strains of streptococcus resistant to two different categories of drugs.
For each organism, the report explains why it is a public health threat, where the trends are headed, what actions the CDC is taking, and what it is important for health care institutions, patients and their families, and states and local authorities to do to help.
Commenting on the report, Ed Septimus MD, professor of internal medicine at Texas A&M Health Sciences Center in Houston says “It’s up to us to make the recommendations in this report happen. If we do nothing but say, ‘Here’s the problem,’ then the problem will continue to grow.”
Well said Doctor, well said.