Every year in the US, more than two million people are infected with a bacteria that is resistant to antibiotics, and more than 20,000 people die every year due to such infections.
Many more Americans die every year from conditions that are complicated by an infection that is resistant to antibiotics. This is a growing public health problem that many public health professionals are having to spend much more time combating.
Antibiotic resistance represents a looming pandemic that will affect nearly all aspects of modern medicine. Common infections that are currently relatively easy to treat will become serious threats. While this threats has been recognized for some time, public policy has yet to get serious about tackling the problem. This is especially true in modern agriculture where antibiotic use is rampant and largely unregulated, which provides breeding grounds for new and more virulent bacteria.
A recent CDC report highlights the growing pandemic of superbugs that have out-evolved even our best antibiotics.
Antibiotic use in the meat and poultry industry has skyrocketed over the past decade. Nearly 30 million pounds were sold for livestock use in the U.S. in 2011, almost four times the amount used by humans. That means 73 percent of all antibiotics sold in America go to meat production.
Infections that are resistant to antibiotics may happen anywhere. Data indicates that most occur in the general US community.
The CDC report, Antibiotic resistance threats in the United States, 2013 gives a first-ever snapshot of the burden and threats posed by the antibiotic-resistant germs having the most impact on human health.
The CDC has sent out a serious warning about bacteria that is resistant to many strong antibiotics. And these strains of bacteria are spreading fast. The video below shows what has caused these bacteria to mutate and what you can do to protect yourself.
The report is a good reference for anyone who needs information about resistance to antibiotics. It is designed to be easy to access for many different audiences. It covers many types of bacteria that can cause severe infections in humans, and the antibiotics that are currently used to treat such infections. Also, Candida, which is a fungus that can cause serious illnesses, also is included because it is showing a higher resistance to drugs that are being used for treatment.
Drug resistance that is related to HIV and influenza are not in this report, and drug resistance to malaria is not included either. These, the report notes, are very important problems, but are beyond the scope of this particular report.
The introduction of the CDC report states that infections that are resistant to antibiotics can cause serious and avoidable costs to an overburdened health care system. In many cases, these infections require longer and more expensive treatments, longer hospital stays, more doctor visits and hospital visits, and the result is more death and disability when compared to infections that can be treated with antibiotics. The total cost to the economy of antibiotic resistance in the US has been hard to figure, but estimates are as high as $20 billion in extra health care costs, and $35 billion a year for additional costs to society in terms of lost productivity.
Antibiotic use is the most important reason that antibiotic resistance is increasing around the world. Antibiotics are some of the most frequently prescribed drugs that are used in human medicine. However, as much as 50% of all antibiotics that are prescribed are not needed, or are not as effective as they are prescribed to be. Antibiotics also are often used in animal feed to prevent disease, and to promote growth of animals that produce food. Antibiotic use to promote growth is not needed, the CDC report states, and the practice should be stopped.
Another major reason for the growth of antibiotic resistance is the increase of resistant strains of many types of bacteria that are spread from one person to the other, or from sources that are non human in our environment, including food.
There are four actions that the report states will help to fight such deadly infections:
Stop infections and stop the spread of resistance
Track bacteria that is resistant to antibiotics
Improve use of antibiotics in medicine
Promote the growth of new antibiotics, and develop new tests for resistant bacteria
The report states that while many bacterial resistance problems are serious, gram-negative pathogens are a particular problem. They are getting more resistant to all types of drugs that may be considered for treatment. The report notes that the most serious infections are associated with health care, and the most common ones are Enterobacteriaceae, pseudomonas aeruginosa, and acinetobacter.
The news of four deaths in Denmark caused by infections from livestock associated (LA) resistant germs has not reached European authorities, except through media reports.
The European Centre for Disease Prevention and Control (ECDC), based in Solna, Sweden keeps no record of infections from different strains of resistant bacteria.
Dominique L. Monnet, Head of the Antimicrobial Resistance and Healthcare-Associated Infections Programme at ECDC, explains in a written comment:
No EU survey on human infections due to LA–MRSA CC398 is currently planned by ECDC. In most European Union member states, MRSA infections are mostly associated with healthcare. The focus of ECDC is therefore on surveillance and prevention and control of healthcare-associated infections, including healthcare-associated infections due to MRSA.
EU-commission has no knowledge of dangerous big-bacteria
Anne Glover, Chief Scientific Adviser to the President of the EU-commission José Manuel Barroso, adds to this when asked by Investigative Reporting Denmark:
“If the ECDC does not know, then there is no knowledge of this in the Commission either. But I will pass on your question to our newly formed working group of scientific advisers.”
The unknown figures of how germs spread from animals to man is not the only grey area concerning antibiotic resistance.
Estimated in 2009: 25,100 deaths caused by resistant bacteria:
The first and so far only scientific study on a European level was done by ECDC and European Medicines Agency, EMA, in London, UK in 2009. The report, ”Time to react”, was based on data collected two years earlier.
The report estimated a death toll of 25,100 per year– which covers the effects of all different kinds of antibiotic resistance, not only from MRSA – and has become an established number since.
Most likely it is set far too low.
Underestimated numbers of deaths caused by resistant bacteria
Otto Cars, a professor of Infectious Diseases at Uppsala University in Sweden and a chairman of ReAct, a network and campaign organization on antibiotic resistance, says there are only three global studies on the subject:
The EU-study from 2009, a study from Thailand 2012 claiming 38,000 yearly deaths, and a US-study 2013 finding 23,000 extra deaths per year.
“There are most likely considerable underestimates in all these studies, as they have only documented some infections from chosen bacteria,” comments professor Cars.
A recent study by the German Association for Hospital Hygiene, Deutsche Gesellschaft für Krankenhaushygiene, estimates as many as 42,000 yearly deaths from hospital-acquired infections in the country, although the role of resistant germs is not specified.
Antibiotic resistance – a threat with the same magnitude as global warming
In spite of weak data on the actual conditions, scientists are in very little doubt about the perspectives.
At an annual conference EuroScience Open Forum held in Copenhagen in June 2014 attention was given to ‘antibiotic resistance as a threat with the same magnitude as global warming.’
“To the individual patient the side effects of antibiotics are small, but they are truly large for society. That’s why the use of antibiotics cannot be a choice by the individual. The use should only be allowed on prescription. And we ought to take to the streets to protest against the excessive use in agriculture,” she said.
Analogy of a tsunami built up in slow motion
Henrik C. Wegener, Chief Academic Officer at Technical University of Denmark, made the analogy of a tsunami built up in slow motion:
“We are standing on the shore, watching the wave rolling in and keep discussing whether we should build dykes or ditches or learn to swim.”
- Introduction [page 11]
- National Summary Data [page 13]
- Cycle of Resistance Infographics [page 14]
- Minimum Estimates of Morbidity and Mortality from
Antibiotic-Resistant Infections [page 15]
- Limitations of Estimating the Burden of Disease Associated
with Antibiotic-Resistant Bacteria [page 18]
- Assessment of Domestic Antibiotic-Resistant Threats [page 20]
- Running Out of Drugs to Treat Serious Gram-Negative Infections [page 22]
- People at Especially High Risk [page 24]
- Antibiotic Safety [page 25]
- Gaps in Knowledge of Antibiotic Resistance [page 27]
- Developing Resistance: Timeline of Key Antibiotic Resistance Events [page 28]
- 2. Tracking Resistance Patterns [page 39]
- 3. Antibiotic Stewardship: Improving Prescribing, Improving Use [page 41]
- 4. Developing New Antibiotics and Diagnostic Tests [page 44]
Important documents from the Copenhagen-conference:
For more discussion on antibiotic resistant threats, please see these insightful sources: