The Centers for Disease Control and Prevention have released a new warning about "superbugs" that includes the latest national death and infection estimates. The warning is important because the federal public health agency says "everyone is at risk" for antibiotic-resistant infections.
The CDC reports more than 2.8 million antibiotic-resistant infections occur in the United States each year and more than 35,000 people die as a result. In total, there are 21 threats in this new warning.
One of the greatest threats is from Clostridioides difficile, "which causes causes life-threatening diarrhea and colitis (an inflammation of the colon), mostly in people who have had both recent medical care and antibiotics." The CDC reports 223,900 cases in 2017 and at least 12,800 deaths.
Why is this important?
Dr. Kevin Shiley, an Infectious Disease physician and the Medical Director for Infection Prevention and Control for Catholic Health, said antibiotics have been used over the decades as a "cornerstone of treatment" for many conditions, from colds to cancers. He said not only does the report point to the profound impact on the patient population because of the number of conditions, but how common these drug-resistant infections have become.
"In a day-to-day basis, we routinely see patients in the community who are affected by these infections," Shiley said. "This is really a large national issue, and international issue frankly."
Shiley said antibiotics traditionally were given out of caution, but there has been a "real shift" in the way physicians prescribe, here in Western New York and across the country, because of drug-resistent superbugs.
"We can't just be giving antibiotics for things we have a strong sense are not caused by bacteria," he said. "I think the public needs to understand that the use of antibiotics for things that are unlikely to be beneficial really doesn't just pose potential harm to the public at large in terms of developing resistance in the community, but it can pose potential harm directly to them with unnecessary treatments."
Shiley said MRSA (methicillin-resistant Staphylococcus aureus) is a common resistent and potentially life-threatening skin infection that developed from the overuse of antibiotics. He said physicians now "very quickly evaluate" whether a patient has any risk factors for harboring a resistent bacteria.
Patients should expect changing practices from their healthcare provider.
"A patient presenting to the hospital, for example, that has had antibiotics, say, within the past 90 days prior to arrival for any number of conditions, or a patient that has spent time in a nursing home or in a dialysis center or in a healthcare facility for any kind of period of time, it would automatically be considered someone who we would oftentimes give much broader-spectrum antibiotics to, simply because we know the likelihood of a resistent bacterial infection in that group of people," Shiley said.
Shiley said there has been a big push from the infectious disease community over the past 15 years for "antimicrobial stewardship" - basically, the wise use of antibiotics - in hospitals and it has spread more recently to outpatient facilities. Likewise, he said drug manufacturers are being pushed to develop antimicrobials to help in the battle against superbugs. There are a number of challenges with that, however.
"The newest drugs that have been developed in response to these highly-resistent bacteria, they are very, very expensive and there usually are a lot of hurdles to go through to get a patient on these medications," he said. "Some of the common medications that are used for highly-resistent bacteria are hundreds, sometimes thousands, of dollars per day to prescribe."
Read the entire CDC report here.