The Rise of Deadly Pathogens: Our New Norm
What the CDC is Saying about Antibiotic Resistance
By Rosie Lyles, MD, MHA, MSc | November 20, 2019
The Centers for Disease Control and Prevention (CDC) released Antibiotic Resistance Threats in the United States, 2019, showing that antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths in the United States each year. This means, on average, someone in the United States gets an antibiotic-resistant infection every 11 seconds, and every 15 minutes someone dies. According to a 2016 report, antibiotic resistance will cause 10 million deaths per year worldwide by 2050, eclipsing the World Health Organization’s 2018 estimate of 9.6 million global cancer deaths.
In the report, the CDC expressed concern about specific antibiotic-resistant infections that are on the rise. They include the following:
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae
ESBL-producing Enterobacteriaceae are one of the leading causes of death from resistant germs. They make urinary tract infections harder to treat, especially in women, and could undo progress made in hospitals if allowed to spread there.
More than half a million resistant gonorrhea infections occur each year, twice as many as reported in 2013. Gonorrhea-causing bacteria have developed resistance to all but one class of antibiotics, and half of all infections are resistant to at least one antibiotic.
Erythromycin-resistant group A Streptococcus
Erythromycin-resistant group A Streptococcus infections have quadrupled since the 2013 report. If resistance continues to grow, infections and deaths could rise.
Antibiotic-resistant germs often found in healthcare
Common hospital-acquired germs include Carbapenem-resistant Enterobacteriaceae (CRE) and methicillin-resistant Staphylococcus aureus (MRSA), which caused more than 85 percent of the total deaths calculated in the report.
The CDC also identified 18 organisms associated with antibiotic resistance concerns and organized them into one of three categories: urgent, serious and concerning. The following five are considered urgent organisms, meaning they constitute public health threats that require urgent and aggressive action:
- Carbapenem-resistant Acinetobacter
- Candida auris (C.auris)
- Clostridioides difficile (C. difficile) previously Clostridium difficile
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Drug-resistant Neisseria gonorrhoeae (N. gonorrhoeae)
Every four hours, the CDC’s Antibiotic Resistance Lab Network detects a resistance germ that required a public health investigation. And more people in the United States are dying from antibiotic-resistant infections than previously estimates. The CDC proposes five core actions to better prepare the United States for the resistance that will continue to emerge worldwide:
- Infection prevention and control
- Tracking and data
- Antibiotic use and access
- Vaccines, therapeutics and diagnostics
- Environment and sanitation
As healthcare professionals, we have to protect people by preventing infections and the spread of multi-drug resistant organisms (MDROs) with universal infection control bundled strategies to avoid a cascade of unfortunate events like the following: patients becoming colonized or infected with a MDRO> pathogens shedding from the patient and contaminating the environment> contamination persisting > staff failing to clean or disinfect > staff acquiring pathogens > staff failing to maintain optimal hand hygiene to effectively remove pathogens > pathogens transferring onto another patient, putting them at risk for infection.
A bundled approach should include the following to help reduce the prevalence of MDROs and resistance patterns across the continuum of care:
- Optimal hand hygiene
- Daily environmental cleaning and disinfecting
- Prudent use of contact precautions or enhanced barrier precautions
- Decolonization with an antiseptic
- Antimicrobial stewardship (shorter equals better)
- Staff education with ongoing training and give real time feedback
Infection control strategies, like Medline’s ERASE Program, are a force when they’re implemented and consistently together; all are equally important and essential in the fight against MDROs. Focusing on these will not only help the United States but the global community combat antibiotic resistance.
Learn more about Medline’s comprehensive solutions for fighting hospital-acquired infections.
The featured image is a medical illustration of the drug-resistant fungus, Candida auris. (Stephanie Rossow/CDC)
Rosie Lyles, MD
Director of Clinical Affairs
Rosie Lyles, MD, MHA, MSc is the director of clinical affairs at Medline. She was previously the head of clinical affairs at Clorox Healthcare where she served as the medical/clinical expert and primary medical science liaison for three healthcare businesses, supporting all scientific research, as well as clinical and product intervention design and development. Lyles has more than a decade of experience investigating hospital-associated infections (HAIs) with a particular focus on the epidemiology and prevention of multidrug-resistant organisms such as C. difficile, MRSA and CRE infections in acute care hospitals and long-term acute care hospitals as a physician-researcher at Cook County Health and Hospitals System. Lyles has also directed numerous clinical studies and interventions for the CDC and the Chicago Antimicrobial Resistance and Infection Prevention Epicenter with numerous authored peer-reviewed journal articles related to infectious disease epidemiology. She is an active member of the Infectious Disease Society of America, Association for Healthcare Environment and the Society for Healthcare Epidemiology of America. Currently she serves as a grant reviewer for the National Institutes of Health/National Institute of Allergy and Infectious Diseases (NIH / NIAID), manuscript reviewer for New England Journal of Medicine, American Journal of Infection Control, medical reviewer for U.S. Department of Veterans Affairs for HSR&D Scientific Merit Board, and Medical Advisory Board for C. Diff Foundation. Rosie received her medical degree from St. Matthew's University School of Medicine and completed a master's in Health Service Administration at St. Joseph College and a master's of Science in Clinical Research and Translational Sciences at the University of Illinois at Chicago.