By Tom Frieden, Special to CNN
Editor’s note: Dr. Tom Frieden is the director for the Center for Disease Control. The views expressed are his own.
Today’s interconnected world means we’re all linked by the air we breathe, the water we drink, the food we eat – and the antibiotics we use.
Global travel speeds the rate at which infectious disease threats can be delivered to our doorstep. We’ve seen antibiotic resistance travel the globe. Take Carbapenem-resistant Enterobacteriaceae or CRE. This really is a nightmare bacteria, resistant to most, and in some cases all, antibiotics. These microbes are especially deadly, and they can pass their resistance to other microbes through “jumping genes” or plasmids. One type of CRE was first seen in one U.S. state. Now it’s spread to 44. It’s also a recognized problem in other countries.
Right now, CRE are found primarily in hospitals. But if these microbes become more common in the community, then urinary tract infections, wounds and other common infections will be extremely difficult or even impossible to treat. It’s a terrible scenario – one that puts all of us at risk.
To help draw attention to CRE and other top antibiotic-resistance threats, the Center for Disease Control recently published its first report on the current antibiotic resistance threat to the U.S. The report estimates that each year in the United States, at least 2 million people become infected with bacteria resistant to antibiotics, and at least 23,000 people die as a result.
It’s a big problem, and one that’s getting worse. But we published this report because it’s not too late – there’s a lot we can do to slow down, and even reverse, antibiotic resistance.
Clinicians, healthcare facility leaders, public health professionals, leaders in agriculture, policymakers, and patients all have a role to play in reversing the current resistance trends. Through concerted commitment to immunization, infection control, protecting the food supply, antibiotic stewardship, and reducing person-to-person transmission we can keep new resistance from developing and prevent the resistance that already exists from spreading.
More from CNN: Doctors still overprescribing antibiotics
Indeed, there are four core actions that between us we can and should be taking:
Prevent: Drug-resistant infections can be prevented by immunization, infection control in healthcare settings, safe food preparation and handling and hand washing.
Track: CDC collects and analyzes data on antibiotic-resistant infections to understand their causes and to discover which people more likely to be infected and to help find and stop outbreaks.
Improve use: Every doctor must commit to use antibiotics only when needed, and to use antibiotics for only as long as they are needed. Patients need to understand that “more” drugs does not equal “better” drugs. The right treatment is the best treatment – and that isn’t antibiotics for every infection or every illness.
Develop new drugs and diagnostic tests: It’s important that we restart the pipeline and provide incentives to companies to do this research. Still, it might be 10 years before the next antibiotic is available, and unless we improve systems to prevent resistance, we will lose these new drugs as well.
The president’s budget has a request for an increase of $40 million so we can better use advanced molecular techniques to find resistant and other deadly microbes and stop them faster. But whatever resources are entrusted to us, we’re going to use them as effectively as we can to protect Americans, because that’s what we’re here to do.
In the meantime, we’re also working with other countries to help them build their systems to find, stop and prevent health threats, because there are too many blind spots around the world. We help them increase laboratory and prevention capacity so threats are detected accurately and stopped sooner.
We work with our international partners such as the World Health Organization and ministries of health to improve tracking and prevention of antibiotic resistance and better protection of the antibiotics we have today.
That protects them – and it protects Americans.
If they keep pushing to lower the cost of prescriptions then new drugs will not be researched as easily as before. It just wont be cost effective. $40 million? That is not even a drop in the bucket of what it will cost to find a new antibiotic
Research Paper: Light DW, Lexchin JR. Pharmaceutical research and development: what do we get for all that money?
Summary: Big pharma spends 19 times as much on advertising as it does on research
One of the biggest abusers of antibiotics in this country are farmers for all farm animals. If this practice was outlawed, our antibiotic resistance would be slowed down!
Thank you for mentioning the "elephant in the room" that this article failed to even mention. The vast majority of antibiotic's most flagrant over use is in feeding antibiotics routinely to animals that are not being treated for infections.
Here's a less scrubbed version of the same story: https://medium.com/p/892b57499e77
Food, medicine and population.. The trifecta of problem for the human species. More population equals the need to use methods to be able to produce more usable food thus drawing on the need for more antibiotics in the livestock and use of pesticides on plants which in turn causes resistance in the germs and lower resistance due to pesticides being consumed. More food also equals more people to the point of reaching carrying capacity compounding the problem. Not really a way out of this except huge swaths of the population dying off in some catastrophic event ( disease, war, climate) which will happen as nature always reverts to equilibrium.
Wow, aren't you a ray of sunshine??? I guess when this plague hits you'll be the first to volunteer to go, eh? People like you always want it to be someone else.
How has the OP at all implied any of the accusations you make against him. If anyone is not the "ray of sunshine", it is you, for being a bitter internet boy.
Unfortunately, you are right. It happened on smaller albeit not too small during several times in world history. Where people died due to unsanitary conditions and over-population in their communities and communicable diseases were transmitted quickly as communities grew and expanded due to commercial, exploration and trading activities. A prime example were the thousands of American Indians killed by small pox to which they had never been exposed.
All animal products are loaded with hormones, antibiotics and other drugs that we consume and it is making us weaker and less able to resist diseases.
You nailed it!
also fruit and veg farmers who are using these drugs, genetic modifications that makes our body resistant to many
antibiotics and increase our food allergies. From the coffee we drink to the soap we use all are altered no one care about consumer they want us think they do care but they care only for almighty dollar..
"10years before next antibiotic is available" ?? There is no question that We Don't Have 10years...w/ CRE, MRSA etc already upon us , we are in dire need of options Right Now before we start dying like flies. Fortunately , there are a 'few' (too few) researchers that have conscientiously towed the line & pursued antibiotics (& nanotech) research all-the-same. Here is an encouraging development in that vein that was just announced this week, concerning a new MRSA therapy that actually 'works': http://medicalxpress.com/news/2013-11-acyldepsipeptide-compound-drug-resistant-bacteria.html#! ...and here's another new finding regarding 'staph infection therapy': http://medicalxpress.com/news/2013-11-staphylococcus-aureus-bacteria-immune.html#!
There are several effective alternatives to antibiotics that have been suppressed by the pharma cartels- Google: colloidal silver (which easily cures MRSA and many other bacterial and viral infections); zappers ;olive leaf extract, etc. this so-called crisis would be non-existent if these remedies were not so viciously suppressed.
I think of these resistant germs every time I`m standing in line at the grocery store next to a nurse in "clean" scrubs. There should be a law against that. Scrubs should stay inside the hospitals, like it is practice in other countries.
Pharma companies care only about making money, and developing new antibiotics is a huge potential money pit. The "newest" antibiotics have been around for about 10 years by now, and to think that the next one is 10 years in the future is scary.
Scrubs should not be worn outside a sterile environment (i.e. isolation ward).
When I use the restroom and wash my hands with SOAP AND WATER and I see other women leaving without doing so, I cringe. If there were only some socially acceptable way to remind people. Also, many, no most of the signs in restaurants, etc., remind employees to wash their hands, but the signs don't even mention SOAP. Some people think running their fingers under running water is good enough, but it's not. Oprah did a show about this very subject.
I see this a lot with men too. After I was my hands and dry them, I take a paper towel and use it on the handle of the exit door. Some people are simply just plain old Neanderthal moron rednecks.
I am finishing up a semester of microbiology. My prof emailed this article to us, and I feel like I should comment here. Are you even remotely aware that most pathogenic bacteria are resistant to the "disinfecting" agent Triclosan? Yes, that is in MOST antibacterial soaps. Unfortunately Triclosan DOES kill off the beneficial bacteria that are on your skin. Pathogens...well they are like little thugs and are opportunistic. They cannot really get a toehold in UNLESS a way has been made for them with "antimicrobial" agents such as Triclosan. Truth be told (and my lab adheres to this), simple soap and water will keep the pathogens away by maintaining the population of the beneficial bateria on your skin and by just sloughing off the topmost layer of those bacteria...which is the most likely to contain pathogens.
I'm not taking any semester of microbiology and can tell you through common sense that triclosan or any chemical used to kill bacteria will ALSO produce resistant BENEFICIAL bacteria. The chemical doesn't discern the difference between good and bad bacteria and the bacteria don't sit there and take a vote as to whether the good guys or bad guys should die. Spray some bugs that you think are harmless with bug spray, and then spray some irrate hornets with the same spray and they both will eventually require a stronger or different spray to kill them if their biological processes (reproduction rate) etc are similar. Remember, mild soap and water washes bacteria from you and will probably not kill the bacteria, therefore there is no resistance developed...win,win. The solution in my opinion is to go away from all antibiotics altogether and allow our bodies to develop resistance naturally the way we had for millenia. Unfortunately, this will mean the death of millions before there is balance again because of the technologically created bubble we have put our bodies in.
TRUE! Soap and Water with good friction. Between each event such as between patients/bathroom toilets(especially men after urinating) Covering hand with 'something' when touching door handles. Public Health should continually educate on Bill Boards.
After several admissions I realized where the biggest weak link is-hospitals save money by hiring poor immigrants from the inner city to clean. I watched them clean beds adjacent to me after someone died or was released who had infections, and the job they did was so inefficient and slap dash. No WONDER infections spread! One roommate I had had terrible diarrhea which leaked all the way from her bed to the bathroom. Housekeeping came in with a mop and basically smeared it around. After she was moved to an isolation unit, they came in to clean-changed the sheets, and used the same rag to do a rudimentary wipe down of the table top and bedstand top. No knobs, no sills or other places touched by the woman. Half the bed hardware went uncleaned, and no sanitizing spray was used. I was terrified and disgusted.
We also need to give-up all those anti-bacterial soaps & cleaning supplies that actually contain antibiotics. Those have become the second most egregious use of antibiotics. After that probably comes all the doctors who prescribe old people antibiotics for viral infections just to shut them up or make them think they're getting something to help.
I am amazed that one thing is said and another left out of this article. Antibiotic resistance bacteria have nothing to do vaccines. Vaccines are obviously for viruses which have little to do with bacteria. The thing left out was that 50 to 80% of all antibiotics are given to animals prophylactically! This has to stop to make a significant change in resistant bacteria. Bactria share there resistance so no matter who or where the antibiotics are used it creates resistant bacteria
Many vaccines are for bacteria. The tetanus, diphtheria, pertussis, pneumococcal, and meningococcal vaccines are all for bacterial agents, to name a few.
There were two HUGE elements left out of this article. First, as someone has mentioned already, animals inteded for our food supply are literally pumped full of MASSIVE doses of dozens of antibiotics to keep them healthy long enough to be slaughtered. Then we ingest with their meat the antibiotics, and so are pumping ourselves full of them as well, creating high levels of resistance and immunity when we actually NEED an antibiotic for an infection.
Secondly, HAND SANITIZER HAS TO STOP. I'm as guilty as anyone with this one but honestly it's not just killing the few germs we get on our hands, it's killing the GOOD bacteria that fight off the bad bacteria, including the superbugs. Morever, it's breeding the antibiotic resistant superbugs and bacteria too. We're dooming ourselves. These two small changes could easily be made, but for reasons of money and convenience most companies and people will continue to turn a blind eye to a relatively easy fix, until it's too late.
The most important thing in prevention of infection and reinfection is Hand Washing. This has been proved over and over.
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