On November 13, the CDC issued its 2019 Antibiotic Resistance Threats in the United States report, underscoring the major health threats posed by bacterial and fungal infections that are resistant to treatment with antibiotics. According to the report, these superbugs are responsible for more than 2.8 million infections in this country annually, or a new infection every 11 seconds. “To stop antibiotic resistance, our nation must stop referring to a coming post-antibiotic era — it’s already here,” writes the CDC’s director, Robert Redfield, MD, in a letter accompanying the 148-page report. “You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy.” The report places 18 antibiotic-resistant bacteria and fungi into three categories based on the level of risk to human health: urgent, serious, and concerning.
Two More Superbugs Join the Urgent List
The CDC also added two new germs to the urgent category: Drug-resistant Candida auris and carbapenem-resistant Acinetobacter. “Candida auris is a new species that presented in the last couple of years,” says M. Valeria Fabre, MD, an assistant professor of medicine and an infectious-disease expert at Johns Hopkins University School of Medicine in Baltimore. “It’s a highly resistant yeast that causes invasive infections, such as a bloodstream infection. These are very serious infections, and they’re very resistant to the antifungal treatments that we have,” she says. This bug is typically associated with healthcare settings, such as long-term care facilities. “Elderly people can be at high risk for getting this infection,” Dr. Fabre says. Carbapenem-resistant Acinetobacter is the kind of bacteria that’s really driving antibiotic resistance around the world, according to Fabre. “The term ‘carbapenem-resistant’ is a red flag,” she says. Carbapenems are a class of very effective antibiotic agents. “We usually reserve these medicines for the most resistant infections, so we are talking about an infection that is resistant to this ‘big gun’ antibiotic,” she says. “It’s very commonly seen in patients who require respiratory support in the hospital,” Fabre says. “Patients who get this kind of infection have a very high risk of death.” The three other urgent threats on the CDC list are:
Clostridioides difficile (C. diff), a bacteria that can cause life-threatening diarrhea and colitis (inflammation of the colon)Carbapenem-resistant Enterobacteriaceae, also known as “nightmare bacteria,” which are resistant to nearly all antibioticsDrug-resistant Neisseria gonorrhoeae, which causes the sexually transmitted disease gonorrhea.
Some Signs of Progress in the Fight Against Superbugs
Fabre believes some of the findings in the report are encouraging. “There has been good progress made since the previous report, including an 18 percent reduction in deaths associated with antibiotic-resistant infections,” she says. Much of this overall improvement was driven by a 28 percent reduction in deaths from drug-resistant bugs in hospitals, according to the report. The CDC works to coordinate with other federal agencies and state and local health departments to combat antibiotic resistance, says Lea-Anne Jackson, a CDC spokesperson. The Antibiotic Resistance (AR) Solutions Initiative has invested more than $300 million in state and local health departments since 2016. “The CDC has established the AR Lab Network, supporting nationwide AR lab capacity in every U.S. state and many large cities, including seven regional labs and the National Tuberculosis Molecular Surveillance Center,” she says. The CDC also supports more than 5,000 infection control assessments in nearly as many healthcare facilities to provide recommendations to address identified infection control gaps and stop the spread of resistant germs, according to Jackson. “All these investments are paying off, but they need to continue to be maintained in order to be able to keep up the fight successfully,” says Fabre. In addition to the 18 bugs listed in the report, the CDC placed three threats on its watch list. These are germs that have not spread resistance widely in this country or are extremely rare but that may pose a risk at some point. “We need to continue to be proactive, because you never know when a new resistant pathogen is going to occur,” says Fabre. “With today’s globalization, humans move fast between countries, and therefore bacteria travel fast. That’s because we are what carry them from place to place.”
What Can You Do to Protect Against Superbugs?
There are some steps that people can take to reduce their health risk and to combat antibiotic resistance. “We can reduce our risk of a resistant infection by first reducing our risk of getting an infection,” says Jackson. “Protect yourself by using antibiotics as prescribed by your doctor, and don’t pressure doctors for antibiotics,” she says. Jackson and Fabre suggest a few other common-sense ways to prevent infection:
Get vaccinated. This could help prevent you from getting an infection in the first place.Practice good hygiene. Keep your hands clean at home, at work, and anytime you visit a healthcare setting.Follow safe food prep.If you’re sexually active, use safe sex practices.
