Some pathogens have already become “superbugs” that are resistant to many types of antibiotics.
Already Causing Thousands of Deaths Every YearAccording to the U.S. Centers for Disease Control and Prevention (CDC), about three million people in the United States currently acquire antibiotic-resistant infections each year, causing over 35,000 deaths annually.
Antibiotic resistance, a main part of antimicrobial resistance (AMR), occurs when bacteria evolve and become resistant to the drugs used to treat them. This happens when bacteria mutate or acquire resistance genes, making them able to survive exposure to antibiotics.
Some people are more vulnerable to antibiotic-resistant infections.
These include individuals with weakened immune systems, such as cancer patients and transplant recipients, as well as elderly individuals and young children.
Additionally, people who live or work in health care settings, such as hospitals and long-term care facilities, are at an increased risk of developing antibiotic-resistant infections due to the frequent use of antibiotics in these environments.
MRSA infections can range from mild skin infections to life-threatening bloodstream infections and are especially common in health care settings.
We’ve Lost Ground Since the PandemicIt was reported that among 191 COVID-19 hospitalized patients in Wuhan, 95 percent were treated with antibiotics.
Smith said the U.S. pandemic response was very similar and worsened the problem of antibiotic resistance.
“Infection prevention methods and control of antibiotic use demonstrated an 18 percent reduction in mortality due to antimicrobial-resistant organisms between 2012 and 2017,” said Smith. “The U.S. lost ground combating antimicrobial resistance during the COVID pandemic.”
She explained that the setbacks were due to multiple factors, including the increased use of antibiotics at the beginning of the pandemic for pneumonia that was thought to be bacterial in origin.
Another issue was that the CDC and local departments of health that had been focusing on antimicrobial resistance were repurposed to deal with COVID.
The Era of Rapid Development Has Ended“Early on, 40 or 50 years ago, as antibiotics started to be used and resistances accumulated, the pharmaceutical drug industry was able to discover, and/or create new antibiotics,” said Dr. William Schaffner, professor of preventive medicine in the Department of Health Policy, and professor of medicine in the Division of Infectious Diseases at Vanderbilt University Medical Center.
“So we were able to ‘stay ahead’ of antibiotic resistance because we always had a new antibiotic that we could pull off the proverbial shelf and use,” he continued.
In those early days of drug development, the “easy” antibiotics were discovered, but we’re in a difficult situation now, and advances have slowed.
“So we can’t just research our way out of a problem by creating new antibiotics,” said Schaffner. “Therefore, our options for appropriate therapy become diminished.”
Schaffner said three solutions are being implemented to address the looming crisis:
The first is that physicians are taught to be more prudent in the use of antibiotics. Virtually every hospital now has an antibiotic stewardship program, which supervises the use of antibiotics, and takes corrective action if overuse is detected.
The second is infection prevention, and there are two ways to do that. One is for hospitals to maintain sophisticated infection control programs, and for the general population to keep good hygienic practices.
“We’re constantly making recommendations to the general population about how to shelter your cough, to encourage hand hygiene, all those things to reduce infections so we won’t have to treat,” he said.
The third is through vaccinations.
“There are clearly some vaccines that have been deployed, particularly among children, and they clearly have helped turn around antibiotic resistance in certain bacterial strains,” said Schaffner.
Treatment Is Becoming ‘More Complicated’Schaffner noted other pathogens that are becoming more antibiotic resistant. These include:
He added that the treatment of gonorrhea is also becoming “more complicated,” meaning that it's harder to find drugs that work against the disease, and prescription regimes are more involved.
“The antibiotics we have are more restricted and they have to be given over a period of time,” he explained. “It’s not just one-dose treatment, and of course, compliance with treatment is not always assured, and that becomes a big problem.”
“It occurred around the globe in several different locations and once it gets into a hospital, it can be very vexing to try to get rid of,” said Schaffner.