09/16/2013
Kevin OuttersonThe CDC just published a comprehensive threat assessment on antibiotic resistance. The topline results will be sure to grab headlines:
Three pathogens make the top-tier “urgent threat” list:
- Clostridium difficile
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Drug-resistant Neisseria gonorrhoeae
MRSA didn’t make the “urgent threat” list for two reasons:
(1) the number of cases has declined as hospitals have implemented more effective infection control measures (at the urging of CMS and others). This is good news, demonstrating that reimbursement levers can help improve safety in US hospitals; and
(2) attracted to the MRSA market, a number of companies have brought antibiotics to the market to fill the gap. This is also good news, as it shows the market working (at least in this instance) in antibiotic R&D. I wish we could say the same for CRE and Neisseria gonorrhoeae. As for Clostridium difficile, the ICAAC conference in Denver last week saw multiple presentations on fecal transplantation, with remarkable early results.
Disclosure: I serve on the CDC’s Antimicrobial Resistance Working Group
@koutterson
by robert aylward on September 16th, 2013 at 16:49
As the number of chronic illnesses increases, so too will antibiotic resistance. It’s a heck of a dilemma: risk death from infection now or antibiotic resistance and death from infection later. That’s an anecdotal comment based on my experience with someone with chronic leukemia. And another anecdotal comment about staph. It’s prevalent in my small community, frightfully so. I say frightfully because my grandfather, an army surgeon in both the Spanish American War (in the Philippines) and the Philippine American War that followed, died of staph he had contracted years earlier while serving in the Philippines. A hundred years later and we continue to battle staph.
by Floccina on September 16th, 2013 at 17:22
Very important subject. I saw some hope inspiring news regarding c. diff.
Transplanting feces from a healthy person into the gut of one who is sick can quickly cure severe intestinal infections caused by a dangerous type of bacteria that antibiotics often cannot control.
A new study finds that such transplants cured 15 of 16 people who had recurring infections with Clostridium difficile bacteria, whereas antibiotics cured only 3 of 13 and 4 of 13 patients in two comparison groups. The treatment appears to work by restoring the gut’s normal balance of bacteria, which fight off C. difficile.
by Greg on September 17th, 2013 at 09:12
Based on other new reports, I presume these are numbers of illness and death per year. But, I do not see this information anywhere on the graphic. It is a nice graphic, but it would be useful to tell the reader what the numbers mean.
by Mark Spohr on September 17th, 2013 at 14:28
To me, the most significant part of the report was that it finally acknowledged the role of antibiotics on farms in creating resistance. Antibiotics given to animals make up over 90% of antibiotic use and these are often given in low dose which increases the chance of creating resistance. They recommended that farm use be curtailed.
Of course, the farmers and pharma are all up in arms about this so we shall see how it plays out. Unfortunately, farmers and pharma have lots of money to buy congress so I don’t expect much action.