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Drug-Resistant Superbugs Kill at Least 23,000 People in the U.S. Each Year

The views expressed are those of the author and are not necessarily those of Scientific American.

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Each year, more than two million people in the United States develop antibiotic-resistant infections, and at least 23,000 of them die as a result, says the first-ever national snapshot of the issue. That toll only rises when other conditions exacerbated by these infections are included in the count. Because it’s difficult to attribute a death directly to antibiotic-resistant microbes (as opposed to illnesses that put the person in the hospital to begin with), the U.S. Centers for Disease Control and Prevention says these figures probably underestimate the scale of the problem.

CDC today released the findings as part of a blueprint for addressing the issue, which the agency says is an urgent and growing threat. “Even when alternative treatments exist, research has shown that patients with resistant infections are often much more likely to die, and survivors have significantly longer hospital stays, delayed recuperation and long term disability,” wrote CDC director Thomas Frieden.

The report authors ranked 18 microorganisms associated with drug resistance as urgent, serious or concerning by considering the pathogens’ clinical and economic impact alongside current and future projected incidence; transmissibility; availability of effective antibiotics; and barriers to prevention. Healthcare costs that arise from antibiotic resistance are challenging to pin down, but previous non-CDC estimates suggest that it can boost healthcare costs annually by $20 billion and cost another $35 billion in lost productivity.

“Urgent threats” to human health include the serious diarrheal infection Clostridium difficile, a family of germs that includes Escherichia coli called Carbapenem-resistant enterobacteriaceae (CRE), and Drug-resistant Neisseria gonorrhoeae–the bacteria responsible for the sexually transmitted infection gonorrhea. Collectively, they claim more than 14,500 lives each year, primarily from C. difficile. Although resistance to the antibiotics that treat C. difficile infections is not yet a problem, CDC included it in the list because it is naturally resistant to many drugs used to treat other infections which enables it to spread quickly.

Microbes that present “serious threats,” according to CDC, include multidrug-resistant Acinetobacter, drug-resistant Campylobacter, and fluconazole-resistant Candida (a fungus) and drug-resistant tuberculosis, among others. “Concerning threats” include Vanomycin-resistant Staphyloccous aureus (VRSA).

Antibiotic-resistance most often arises when commercial antibiotics kill good bacteria that protect the body from infection alongside bacteria that cause illness–setting the stage for drug-resistant bacteria to flourish and take over. Some drug-resistant bacteria are then able to exchange genes with other bacteria, spreading resistance and helping sideline drugs normally capable of treating infection.

CDC scientists have long said that the overuse of antibiotics in both humans and animals has contributed to the spread of drug-resistant “superbugs.” In fact, multiple studies during the last decade have found that about half of all antibiotics prescribed in the U.S. are not needed or are inappropriate.The most acute antibiotic resistance problems arise in hospitals, Frieden said today on a conference call. “The most resistant organisms in hospitals are emerging in those settings because of poor antimicrobrial stewardship among humans.”

Antibiotic resistance poses a particular threat to people with compromised immune systems, such as patients undergoing chemotherapy or complex surgeries or individuals with chronic diseases such as diabetes, asthma or rheumatoid arthritis. Most deaths linked to antibiotic-resistant infections happen in hospitals and nursing homes.

Image: CDC

CDC’s prescription for combating these infections has four main components: Preventing infections and the spread of resistance; better tracking of resistant bacteria in order to understand the scope of the problem; improving the use of current antibiotics; and promoting the development of new antibiotics and better diagnostic tests for resistant bacteria.

The report does not say exactly how those objectives should be achieved or how much such an effort would cost. It does, however, recommend steps that states and communities, health providers, healthcare officials, and patients can take. Hospital patients, for example, should insist everyone wash their hands before touching them.

Image: CDC

Two budget items on CDC’s wishlist for FY 2014 give some insight into how the agency hopes to improve its antibiotic-resistance efforts. In the President’s budget, CDC proposed an allocation of $40 million for a new Advanced Molecular Detection initiative, which would advance technologies such as high-throughout genome sequencing and improving bioinformatics. The agency also requested an increase of about $12.5 million for improvements to the National Healthcare Safety Network, which provides an integrated reporting system for healthcare-associated infections. The funds would expand that system to another 1,800 facilities.

To calculate the toll from antibiotic-resistance in this national snapshot CDC gathered existing data on the proportion of antibiotic resistant isolates and multiplied it by the total number of cases or deaths attributed to that bacterium. Since there is no total count for several pathogens, CDC says their estimates of antibiotic-resistant infections are conservative.



About the Author: Dina Fine Maron is the associate editor for health and medicine at Scientific American. Follow on Twitter @Dina_Maron.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. littleredtop 5:04 pm 09/16/2013

    There seems to be a misunderstanding regarding bacteria mutations. Bacteria mutate with every reproductive cycle and if left alone will sooner or later mutate into a strain that does not react to currently available antibiotics. Modern medicine seems to be of the belief that the bacteria are somehow learning to resist antibiotics. Therefore, they typically administer low, short term, doses of antibiotics rather than quickly kill the infection with a high dose. The longer they allow an infection to continue the more likely an antibiotic resistant strain could evolve.

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  2. 2. bucketofsquid 5:17 pm 09/17/2013

    @littleredtop – Some pathogens are not killed by a sudden burst of antibiotic and require repeated exposure. A single dose strong enough to kill all of the targeted pathogens may be very damaging to the patient. Perhaps if you were educated in that particular field you would understand it better. Then again, I’m not particularly educated in that field but just payed attention to my doctors when they explained it to me.

    Either way, the “preventive” use of antibiotics in food animals is exactly the long term low exposure that you correctly point out can lead to resistant bacteria.

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  3. 3. abemordent 6:13 pm 09/17/2013

    All heavy metals, atomic number 27 and up, kill all bacteria, yeasts, molds, and funguses. Colloidal silver is safe, and kills all bacteria, yeasts, molds, and funguses. I have cured all my bacterial infections with colloidal silver. I cured ptomaine poisoning with one eye dropper full of colloidal silver. There are corrupt special interests who don’t want this knowledge known by the general public.

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  4. 4. LindaAllen 7:43 pm 02/4/2015

    It’s more likely that the death rate is higher. Some people have stated as much as 2 million worldwide currently and now they predict 10 million deaths a year from antibiotic resistance by 2050. That’s probably also a low number. There’s a lot of bad news about antibiotics these days –

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  5. 5. DrMcCombs 6:37 pm 04/13/2015

    The “official” word on antibiotic deaths in the US is that 23,000 people die each year from antibiotic-resistant strains. One example of how inaccurate that number is as antibiotic-resistant C. diff alone is responsible for 29,000 deaths. MRSA kills 18,500 a year in the US. There are at least 18 drug-resistant infections that kill people each year in the US.

    The antibiotic articles on Scientific American are a time-capsule of man’s stupidity. Each new antibiotic is heralded as the next big gun, only to fall to the wayside after a few years as bacteria outsmart and evolve resistance to yet another of man’s supposed victories.

    The basic premise remains the same – the use of antibiotics guarantees their obsolescence. Bacteria have 360 genes to every one of man’s and with that an incredible ability to adapt and compensate for everything many can throw at them.

    With this approach, man is creating his own demise. By 2050, over 10 million people will die each year from antibiotic resistant superbugs. Despite all of the warnings from every reutable source around the planet, antibiotic prescriptions continue to rise. Government and world sources state that we will soon return back to the pre-antibiotic era when millions of people died under medical care. What does this tell us? It tells us that in over 66 years, the medical field hasn’t advanced itself beyond throwing pills at people.

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