CDC Threat Report: ‘We Will Soon Be in a Post-Antibiotic Era’

LateX'Dog · 17 Sep 2013 at 08:14

The U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms, ranking them by the number of illnesses and deaths they cause each year and outlining urgent steps that need to be taken to roll back the trend.

The agency’s overall — and, it stressed, conservative — assessment of the problem:

Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics;
Each year, out of those illnesses, 23,000 deaths;
Because of those illnesses and deaths, $20 billion each year in additional healthcare spending;
And beyond the direct healthcare costs, an additional $35 billion lost to society in foregone productivity.

“If we are not careful, we will soon be in a post-antibiotic era,” Dr. Tom Frieden, the CDC’s director, said in a media briefing. “And for some patients and for some microbes, we are already there.”

The report marks the first time the agency has provided hard numbers for the incidence, deaths and cost of all the major resistant organisms. (It had previously estimated illnesses and deaths from some families of organisms or types of drug resistance, but those numbers were never gathered in one place.) It also represents the first time the CDC has ranked resistant organisms by how much and how imminent a threat they pose, using seven criteria: health impact, economic impact, how common the infection is, how easily it spreads, how much further it might spread in the next 10 years, whether there are antibiotics that still work against it, and whether things other than administering antibiotics can be done to curb its spread.

Out of that matrix, their top three “urgent” threats:

Carbapenem-resistant Enterobacteriaceae or CRE, a set of ICU germs that are resistant to almost all antibiotics: 9,000 infections per year, 600 deaths
Antibiotic-resistant gonorrhea, which currently responds to only one drug: 246,000 infections per year
Clostridium difficile, which is growing in resistance to one class of drugs, but more important, serves as a marker for the use of other antibiotics: 250,000 illnesses, 14,000 deaths.

There are 12 resistant bacteria and fungal infections in a second category, which the agency dubs “serious” (requiring “prompt and sustained action”); they include the hospital infections Acinetobacter, Pseudomonas aeruginosa, and VRE; the foodborne organisms Campylobacter, Salmonella and Shigella; MRSA; Candida, a fungal infection; and TB, among others. The last category, “concerning” (requiring “careful monitoring and prevention”) includes rare but potent vancomycin-resistant staph, VRSA, as well as strains of strep resistant to two different categories of drugs.

http://www.wired.com/wiredscience/2013/09/cdc-amr-rpt1/

So I'm a little out of my depth here, so with antibiotic resistant bacteria does that mean there is no way at all to kill the bacteria?

Derek W · 17 Sep 2013 at 08:22

LateX'Dog said:
http://www.wired.com/wiredscience/2013/09/cdc-amr-rpt1/

So I'm a little out of my depth here, so with antibiotic resistant bacteria does that mean there is no way at all to kill the bacteria?

Kill it with fire. There's always a solution!

thep02 · 17 Sep 2013 at 08:25

Colloidal silver, alcohol, t-tree oil, peroxides, macro phages however it's a very scary prospect to not have antibiotics handily available, I blame giving animals on factory farms the same drugs as us primarily to increase growth.

Aod · 17 Sep 2013 at 08:42

thep02 said:
I blame giving animals on factory farms the same drugs as us primarily to increase growth.

That'd be nice except that the origin of Antibiotic-resistant bacteria has been demonstrated to be the over-use and improper use of Antibiotics such as in Russia, India where Antibiotics are given out like candy, even if patients don't have bacterial infections. Additionally, patients not finishing their prescribed courses of Antibiotics are a significant contributing factor.

Fortunately, the number of bacteria that cross the species barrier between humans and livestock is extremely low.

thep02 · 17 Sep 2013 at 08:47

Aod said:
Fortunately, the number of bacteria that cross the species barrier between humans and livestock is extremely low.

That's why I couldn't understand the rush to give pigs and chickens the same drugs as us, often handed out with the food, I used to go out with an Irish pig farmers daughter.

icehot · 17 Sep 2013 at 09:09

We find treatment, bacteria evolves to resist, we then adapt as well with new treatment so on and so forth

Obviously I don't understand how this works as its clearly not that simple..

Suarez7 · 17 Sep 2013 at 09:12

So when does the super mutant stage begin?

d_brennen · 17 Sep 2013 at 09:16

Suarez7 said:
So when does the super mutant stage begin?

It's after the Zombie Era, so there will be bigger things to worry about then

Suarez7 · 17 Sep 2013 at 09:16

d_brennen said:
It's after the Zombie Era, so there will be bigger things to worry about then

Thanks for clearing that up then, nearly had me worried.

Xordium · 17 Sep 2013 at 09:18

I've covered this many times you could use the search button to find the more in detail responses.

The long and short is there will be antibiotic cover for a variety of things, there will be new methods all however will be horribly expensive. So what are the implications: well expect to see life expectancy plummet, you can knock transplant surgery and chemotherapy and gene therapy on the head, expect infant mortality rates to rise, etc etc unless of course you are rich. You can treat without antibiotics but it really requires you to know what you are doing and not may people do what they are doing when it comes to this you are looking at triple figures worldwide at a competent level.

tom_e · 17 Sep 2013 at 09:18

Aod said:
That'd be nice except that the origin of Antibiotic-resistant bacteria has been demonstrated to be the over-use and improper use of Antibiotics such as in Russia, India where Antibiotics are given out like candy, even if patients don't have bacterial infections. Additionally, patients not finishing their prescribed courses of Antibiotics are a significant contributing factor.

Fortunately, the number of bacteria that cross the species barrier between humans and livestock is extremely low.

It's the same here with people going to the doctors with a cold and demanding something to make them feel better so they just get fobbed off with antibiotics that will have no effect, but the patient is happy because they've got drugs.

d_brennen · 17 Sep 2013 at 09:22

tom_e said:
It's the same here with people going to the doctors with a cold and demanding something to make them feel better so they just get fobbed off with antibiotics that will have no effect, but the patient is happy because they've got drugs.

Perhaps more pertinently, the GP gets paid out for prescribing said drugs...

LOAM · 17 Sep 2013 at 09:29

Get fit and stop getting ill.

Aod · 17 Sep 2013 at 09:33

thep02 said:
That's why I couldn't understand the rush to give pigs and chickens the same drugs as us, often handed out with the food, I used to go out with an Irish pig farmers daughter.

Antibiotics are often broadly effective against multiple types of bacteria in multiple host organisms.

icehot said:
We find treatment, bacteria evolves to resist, we then adapt as well with new treatment so on and so forth

Obviously I don't understand how this works as its clearly not that simple..

The difficulty is that drug companies are struggling to come up with new, more effective or potent antibiotics that can be administered without killing people. Many antibiotics which have previously been known as "last resort drugs" due to their potency and significant side effects are now becoming obsolete against more and more resistant bacteria.

If you'd like to understand more, the Wikipedia articles on this subject are quite informative and accurate;
http://en.wikipedia.org/wiki/Antibiotic_resistance
http://en.wikipedia.org/wiki/Vancomycin

tom_e said:
It's the same here with people going to the doctors with a cold and demanding something to make them feel better so they just get fobbed off with antibiotics that will have no effect, but the patient is happy because they've got drugs.

Very true. Fortunately, it's nowhere near as prevalent here in the UK as it is in the US or India. In India, you can buy most antibiotics over the counter without prescription of any kind! Madness

Xordium · 17 Sep 2013 at 09:35

Aod said:
Additionally, patients not finishing their prescribed courses of Antibiotics are a significant contributing factor.

With a lot of these things maybe we should stop blaming other countries and start looking at the massive usage in immunosuppressed patients which is where we see a large amount of the resistance occurring.

Easier to blame them abroad though isn't it than see that the care our families has is directly causing problems.

Aod · 17 Sep 2013 at 09:40

Xordium said:
With a lot of these things maybe we should stop blaming other countries and start looking at the massive usage in immunosuppressed patients which is where we see a large amount of the resistance occurring.

Easier to blame them abroad though isn't it than see that the care our families has is directly causing problems.

What would you recommend in the treatment of Immunosuppressed patients? allow them to die of simple infections that are easily treatable?

As far as I was aware, around three quarters of all cases of extreme drug resistant bacteria had originated from India, Russia, Iran and the US?

Castiel · 17 Sep 2013 at 09:44

Aod said:
What would you recommend in the treatment of Immunosuppressed patients? allow them to die of simple infections that are easily treatable?

As far as I was aware, around three quarters of all cases of extreme drug resistant bacteria had originated from India, Russia, Iran and the US?

and what is that as a percentage factor of their population?

Xordium · 17 Sep 2013 at 09:55

Aod said:
What would you recommend in the treatment of Immunosuppressed patients? allow them to die of simple infections that are easily treatable?

I never said that did I. What I said is that we have to acknowledge the role this has to play.

And there are plenty of reasons why we shouldn't be treating the way we do with our limited resources. And there are other alternatives to explore that means we don't have to immunosuppress for as long or as strongly.

Orionaut · 17 Sep 2013 at 10:11

It will be like life in the 1930's! Hardly the end of the world!

Infant mortality will rise but the counter balance will be that those that do survive to adulthood will generally be tough and will have as good a chance of living into old age as many people today .

Even the classical era had plenty of old people (Ramesses the great reigned for over 60 years!)

The really big improvements in public health took place in the 19th century not the 20th and were as a result of improved sanitation and provision of clean drinking water.

I dont wish to understate the importance of antibiotics as a part of healthcare but at the same time, I think it is important not to overstate it either!

Xordium · 17 Sep 2013 at 10:15

And was the world as crowded then?
Were people in such close proximity is so many places to spread pathogens?
What were the statistics for the majority when they were in such close proximity?
Was there such pronounced movement of populations to spread pathogens?

I've never said it's the end of the world. But it sure as hell will be the end of the world as we know it to be now.