September 17, 2013 - 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.