CDC Calls Attention to Bacteria Resistance
November 8, 2013 04:41 PM
Shortly before the partial government shutdown, the Centers for Disease Control and Prevention (CDC) issued a wakeup call – in the form of a report – on the increasingly alarming growth of antibiotic resistance in the United States, with implications for healthcare providers. Threats to public health were grouped according to risk levels: Urgent, Serious, and Concerning. The Urgent or greatest risk category includes a bacterium that has gotten much attention in recent years, Clostridium difficile (C. difficile). CDC emphasizes that C. diff, as it is known, can cause life-threatening diarrhea. The report notes infections “mostly occur in people who have had both recent medical care and antibiotics. Often, C. difficile infections occur in hospitalized or recently hospitalized patients” or nursing home patients, those with a weakened immune system who were exposed to multiple antibiotics or long-term use.
In 2000, a stronger strain of the bacteria emerged, CDC adds. “This strain is resistant to fluoroquinolone antibiotics, which are commonly used to treat other infections.” Deaths related to C. difficile increased 400 percent between 2000 and 2007.
The pathogen is responsible for 250,000 infections per year requiring hospitalization or affecting already hospitalized patients. “In most of these infections, the use of antibiotics was a major contributing factor leading to the illness. At least 14,000 people die each year in the United States from C. difficile infections. Many of these infections could have been prevented.” More than 90 percent of deaths occur in people 65 and older.
Among the recommendations, healthcare providers were urged to order a C. diff test - preferably a nucleic acid amplification test - if the patient has had three or more unformed stools within 24 hours. Prescribe antibiotics “carefully,” as suggested in CDC “get smart” guidelines. “Once culture results are available, check whether the prescribed antibiotics are correct and necessary.”
Also in the Urgent category are carbapenem-resistant Enterobacteriaceae (CRE) and antibiotic-resistant Neisseria gonorrhoeae.
In the report’s “Serious” or middle-risk category are a dozen pathogens, including those long familiar to healthcare such as Methicillin-resistant Staphylococcus aureus (MRSA), responsible for 11,285 deaths a year, with recommendations for providers. The report also discusses usage of and resistance to specific antibiotics and problems in new antibiotics development. “Each year in the United States, at least 2 million people acquire serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections. At least 23,000 people die each year as a direct result of these antibiotic-resistant infections.”
“Perhaps the single most important action needed to greatly slow down the development and spread of antibiotic-resistant infections is to change the way antibiotics are used. Up to half of antibiotic use in humans and much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe.” Title of the 114-page report: Antibiotic Resistance Threats in the United States, 2013.