CDC works 24/7 to save lives and protect people. Part of that responsibility includes sounding the alarm about health threats.
Today, we are publishing a report about what happens when microbes outsmart our best drugs.
By our most minimal estimate, at least two million people per year in the United States get infections that are resistant to antibiotics and at least 23,000 people die as a result. For some microbes and some patients, our medicine cabinet is nearly empty and we can no longer treat patients.
This landmark report gives us the first snapshot of antibiotic resistance threats with the most impact on human health. Many numbers are new, and some existing, but this is the first time they have been put together and ranked to give an overall picture of antibiotic resistance in the United States.
Many people view antibiotic resistance as a problem that happens somewhere else -- other medical practices or facilities, other farms, other people.
This report shows that antibiotic resistance is happening here, in your community, in your healthcare facility, in your medical practice, and on the farms that feed us.
Most of the 18 microbes included in this report are common. Urgent threats include three bacteria: CRE or carbapenem-resistant Enterobacteriaceae, Clostridium difficile, and drug-resistant gonorrhea.
Urgent Threats Require Urgent Action
Without urgent and aggressive action, more patients will be thrust back to a time when simple infections can be deadly. And, the loss of effective antibiotics will undermine treatment of infectious complications in patients with other diseases. Many medical advances -- joint replacements, organ transplants, cancer therapy, diabetes treatment, rheumatoid arthritis therapy -- depend on the ability to fight infections with antibiotics.
Until now, we've stayed one step ahead of disaster through the development of new drugs. Today, experts estimate that new drugs could be a decade or more away. That's 10 years of more lives lost because of drug-resistant infections. We can do better.
CDC Recommends Four Core Actions
Saving antibiotics won't be easy, but we now know how to prevent and reverse antibiotic resistance -- we just need to do it. There's still time. But not much time.
CRE, carbapenem-resistant Enterobacteriaceae, are the “nightmare bacteria” we <a href="http://www.cdc.gov/vitalsigns/hai/cre/" target="_blank">reported</a> on in March. These include bacteria that can resist all antibiotics, kill a high number of people who get it in their blood, and spread their resistance capabilities to other bacteria.
<em>C.difficile</em>, a life-threatening infection causing deadly diarrhea, causes at least 250,000 hospitalizations and 14,000 deaths each year. Although not significantly resistant itself, <em>C. difficile</em> infections usually happen to people who are taking or who recently took antibiotics, or who caught the infection from those who did.
Thirty percent of gonorrhea infections are caused by microbes resistant to at least one antibiotic. If gonorrhea becomes resistant to antibiotics called cephalosporins, there could be an estimated 75,000 additional cases of pelvic inflammatory disease, a major cause of infertility. I’ve taken care of patients with infected joints from gonorrhea which has spread – a complication that can be disabling, painful, and expensive to treat.
<em>Acinetobacter</em> is a type of gram-negative bacteria that is a cause of pneumonia or bloodstream infections among critically ill patients. Many of these bacteria have become very resistant to antibiotics.
<em>Campylobacter</em> usually causes diarrhea (often bloody), fever, and abdominal cramps, and sometimes causes serious complications such as temporary paralysis.
Candidiasis is a fungal infection causes by yeasts of the genus Candida. Candida is the fourth most common cause of healthcare-associated bloodstream infections in the United States. In some hospitals it is the most common causes. These infections tend to occur in the sickest patients.
Extended-spectrum β-lactamase is an enzyme that allows bacteria to become resistant to a wide variety of penicillins and cephalosporins. Bacteria that contain this enzyme are known as ESBLs or ESBLproducing bacteria. ESBL-producing Enterobacteriaceae are resistant to strong antibiotics including extended spectrum cephalosporins.
Enterococci cause a range of illnesses, mostly among patients receiving healthcare, but include bloodstream infections, surgical site infections, and urinary tract infections.
<em>Pseudomonas aeruginosa</em> is a common cause of healthcare-associated infections including pneumonia, bloodstream infections, urinary tract infections, and surgical site infections.
Non-typhoidal <em>Salmonella</em> (serotypes other than Typhi, Paratyphi A, Paratyphi B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and abdominal cramps. Some infections spread to the blood and can have life-threatening complications.
<em>Salmonella</em> serotype Typhi causes typhoid fever, a potentially life-threatening disease. People with typhoid fever usually have a high fever, abdominal pain, and headache. Typhoid fever can lead to bowel perforation, shock, and death.
<em>Shigella</em> usually causes diarrhea (sometimes bloody), fever, and abdominal pain. Sometimes it causes serious complications such as reactive arthritis. High-risk groups include young children, people with inadequate handwashing and hygiene habits, and men who have sex with men.
Methicillin-resistant <em>Staphylococcus</em> aureus (MRSA) causes a range of illnesses, from skin and wound infections to pneumonia and bloodstream infections that can cause sepsis and death. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.
<em>Streptococcus pneumoniae</em> (<em>S. pneumoniae</em>, or pneumococcus) is the leading cause of bacterial pneumonia and meningitis in the United States. It is also a major cause of bloodstream infections and ear and sinus infections.
Tuberculosis (TB) is among the most common infectious diseases and a frequent cause of death worldwide. TB is caused by the bacteria <em>Mycobacterium tuberculosis</em> (<em>M. tuberculosis</em>) and is spread most commonly through the air. M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. In most cases, TB is treatable and curable with the available first-line TB drugs; however, in some cases, <em>M. tuberculosis</em> can be resistant to one or more of the drugs used to treat it. Drug-resistant TB is more challenging to treat — it can be complex and requires more time and more expensive drugs that often have more side effects. Extensively Drug-Resistant TB (XDR TB) is resistant to most TB drugs; therefore, patients are left with treatment options that are much less effective. The major factors driving TB drug resistance are incomplete or wrong treatment, short drug supply, and lack of new drugs. In the United States most drug-resistant TB is found among persons born outside of the country.
<em>Staphylococcus aureus</em> is a common type of bacteria that is found on the skin. During medical procedures when patients require catheters or ventilators or undergo surgical procedures, Staphylococcus aureus can enter the body and cause infections. When <em>Staphylococcus aureus</em> becomes resistant to vancomycin, there are few treatment options available because vancomycin-resistant <em>S. aureus</em> bacteria identified to date were also resistant to methicillin and other classes of antibiotics.
Group A <em>Streptococcus</em> (GAS) causes many illnesses, including pharyngitis (strep throat), streptococcal toxic shock syndrome, necrotizing fasciitis (“flesh-eating” disease), scarlet fever, rheumatic fever, and skin infections such as impetigo.
Group B <em>Streptococcus</em> (GBS) is a type of bacteria that can cause severe illnesses in people of all ages, ranging from bloodstream infections (sepsis) and pneumonia to meningitis and skin infections.
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