CDC Threat Report - 'We Will Soon Be in A Post-Antibiotic Era' - WIRED

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MARYN MCKENNA 09.16.13 03:40 PM
CDC Threat Report: 'We Will Soon Be in

a Post-Antibiotic Era'
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IMAGE: CDC
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,
ranking them by the number of illnesses and deaths they cause each year and outlining
urgent steps that need to be taken to roll back the trend.
The agency's overall – and, it stressed, conservative – assessment of the problem:

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Because of those illnesses and deaths, $20 billion each year in additional healthcare
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And beyond the direct healthcare costs, an additional $35 billion lost to societySUBSCRIBE
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"If we are not careful, we will soon be in a post-antibiotic era," Dr. Tom Frieden, the
CDC's director, said in a media briefing. "And for some patients and for some microbes,
we are already there."
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 had previously estimated
illnesses and deaths from some families of organisms or types of drug resistance, but
those numbers were never gathered in one place.) 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, and whether things other than
administering antibiotics can be done to curb its spread.
Out of that matrix, their top three "urgent" threats:
Carbapenem-resistant Enterobacteriaceae or CRE, a set of ICU germs that are

resistant to almost all antibiotics: 9,000 infections per year, 600 deaths
Antibiotic-resistant gonorrhea, which currently responds to only one drug: 246,000
infections per year
Clostridium difficile, which is growing in resistance to one class of drugs, but more
important, serves as a marker for the use of other antibiotics: 250,000 illnesses,
14,000 deaths.
There are 12 resistant bacteria and fungal infections in a second category, which the
agency dubs "serious" (requiring "prompt and sustained action"); they include the
hospital infections Acinetobacter, Pseudomonas aeruginosa, and VRE; the foodborne
organisms Campylobacter, Salmonella and Shigella;
Don't miss MRSA; Candida, a fungal infection;
the future
and TB, among others. The last category,
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for unlimited access to "careful monitoring
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For each organism, the report explains why it is a public health threat, where the trends
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also makes explicit where the trend of increasing and more common resistance is taking
the country, outlining the risks to people taking chemotherapy for cancer, undergoing
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surgery, taking dialysis, receiving transplants, and undergoing treatment for rheumatoid
arthritis.
(The report also – and this is so important that I'll take it up in a separate post tomorrow
– tackles the issue of how agriculture, as well as healthcare, contributes to the increase
in resistant organisms nationwide.)
The report lists some serious concerns the CDC has regarding how well resistance is
monitored: in "gaps in knowledge," it specifically names limited national and
international surveillance, as well as the lack of data on agricultural use of antibiotics.
And it calls for action in four areas: gathering better data; preventing infections, through
vaccination, better protective behavior in hospitals, and better food handling; improving
the way in which antibiotics are used, by not using them inappropriately in health care
or agriculture; and developing not just new categories of antibiotics but better
diagnostic tests so that resistant organisms can be identified and dealt with sooner,
before they spread.
In an interview before the report became public, Frieden said that some of these actions
are already happening. "My biggest frustration is the pace of change," he told me.
"Hospitals are making progress, but it’s single digits in terms of the number of hospitals
that are being very proactive. The challenge is scaling up what we know works, and
doing that fast enough so that we can close the door on drug resistance before it’s too
late."
I talked about the report's calls for action to Dr. Ed Septimus, who is a professor of
internal medicine at Texas A&M Health Sciences Center in Houston and a frequent
spokesperson for the Infectious Diseases Society of America, the professional group for
the physicians who usually treat resistant infections.
"We have gotten some action in Congress," he said, mentioning the GAIN Act, which
passed and offers incentives for drug
Don'tdevelopment, and the STAAR Act, which aimed to
miss the future
improve surveillance and antibiotic
Subscribeconservation, butaccess
today for unlimited did not
to pass. "The FDA is
considering regulations
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other allow
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the print
about for drugs
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and location.
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research understand how
resistance
higher than itFordid 10information
more years ago.seeSo
ourthere
Privacyis movement
Policy and Cookie— but in terms of funding, it is a
Statement
slow difficult process.
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"Still, there are things we can doAlready
without funding," he
a subscriber? Signsaid:
in hospitals could create their
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own stewardship programs, and could work with nursing homes, whose patients bring
some of the most resistant organisms into hospitals but who usually lack the budget for
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infection prevention.
"It's up to us to make the recommendations in this report happen," Septimus said. "If we
do nothing but say, 'Here's the problem,' then the problem will continue to grow."
Cite: Antibiotic Resistance Threats in the United States, 2013, Centers for Disease Control
and Prevention. Sept. 16, 2013.
#ANTIBIOTICS #CDC #CRE #RESISTANCE
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MARYN MCKENNA 09.16.13 03:40 PM

CDC Threat Report: 'We Will Soon Be in

About Cookies On This Site

The agency's overall – and, it stressed, conservative – assessment of the problem:

Out of that matrix, their top three "urgent" threats:

Carbapenem-resistant Enterobacteriaceae or CRE, a set of ICU germs that are

#ANTIBIOTICS #CDC #CRE #RESISTANCE

About Cookies On This Site

Don't miss the future

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How Argentina’s Strict Covid-19 Lockdown Saved Lives

Don't miss the future

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OUR ULTIMATE GUIDE

Everything You Need to Work From Home Like a Pro

About Cookies On This Site

Don't miss the future

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How to Make a CDC-Approved Cloth Face Mask

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Newly Unemployed, andDon't

Enter your email

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