Doctors prescribe sick patients antibiotic drugs with the specific intent of knocking out the viral, bacterial or fungal infections that put them under the weather. But new research shows microbial pests have learned to fight back.
During a Nov. 13 telephone briefing for news media, both Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention (CDC), and Michael Craig of the agency’s Antibiotic Resistance Coordination and Strategy Unit, outlined the situation at hand. Each year, more than 2.8 million infections related to antibiotic resistance take place. More than 35,000 people die from those infections.
Redfield and Craig spoke of the CDC’s newly published white paper on the subject, which reports that nearly 3 million Americans “face an antibiotic-resistant infection.”
The report, titled "Antibiotic Resistance Threats in the United States," identifies 18 known antibiotic-resistant pathogens that must be dealt with before they can proliferate and spread untreatable illnesses. The latest statistics, Redford and Craig said, indicate the problem is far more serious than researchers believed when they prepared the last such report in 2013. Improved measuring methodology has shown that the number of deaths back then was actually twice as high as they believed at the time.
“CDC uses the best data, but [estimates were] conservative at the time,” Craig said.
“It threatens our nation’s health and our global security,” Redfield said. “The good news is we know how to protect ourselves. We’re seeing progress nationwide.”
Related hospital deaths have declined by 18 percent overall and by 30 percent in hospitals alone, Redford said, through the implementation of comprehensive strategies throughout the human and animal health-care professions and agriculture as well.
The CDC is taking a five-pronged approach toward a solution. It entails: infection prevention and control; tracking and sharing data; improving the appropriate use of antibiotics; investment in vaccines, therapeutics and diagnostics; and close monitoring of the environment and sanitation practices.
Within the Military Health System, and particularly at the Uniformed Services University of the Health Sciences, researchers are also taking the issue of antimicrobial resistance seriously.
“Over the last few years we have actively been studying the epidemiology and the outcomes associated with antimicrobial resistance infections in military hospitals,” explained Dr. Allison Malloy, assistant professor and infectious disease faculty, Department of Pediatrics, USU. “Consistent with the CDC findings, we have found a high mortality associated with some of these infections. Across the Department of Defense facilities, we have implemented programs to help control these infections including active surveillance, rapid pathogen identification and targeted treatment, and data-driven antibiotic stewardship programs.”
For example, the Multidrug-Resistant Organism Repository and Surveillance Network (MRSN), under the Walter Reed Army Institute of Research, coordinates analysis and management of antibiotic resistance across the entire military health system. This helps military treatment facilities share information, optimize standard practices for infection control and patient safety, identify an outbreak of a pathogen earlier, and make more appropriate antibiotic selections for patients. MRSN is part of a DoD-wide effort, Antimicrobial Resistance and Monitoring Research Program (ARMoR), which includes DoD hospital laboratories, clinicians and infection control staff; public health reporting groups; Navy and Air Force public health data collection programs; and national policy groups, with the common goal of managing Service programs monitoring antibiotic-resistant bacteria.
“We will continue to monitor for infections and seek to improve the quality of healthcare provided to military members, their families and retirees,” Dr. Malloy said.
While medical community researchers and clinicians are taking action to counter the bad effects of antibiotic resistance, the CDC offered practical advice that would help average citizens mitigate the risks they face. Here are some:
- When visiting a doctor to treat sickness, ask what could make you feel better rather than request antibiotics specifically. If prescribed antibiotics, use them in the manner in which your provider asks.
- Follow good hygiene practices. Wash your hands, be careful when handling food or caring for animals.
- Get vaccinated.
- Practice safe sex.
- Be vigilant when traveling abroad.
Health care providers can do their part as well, the report said, by following good infection prevention and control practices and being more vigilant when prescribing antibiotics. Providers also should take note of infections and resistance patterns where they work and in their communities.