An estimated 35,000 Americans die of antibiotic-resistant infections each year—one every 15 minutes—according to a stark new report from the Centers of Disease Control and Prevention that reveals that the problem is substantially greater than previously estimated.
The new report, the first update of a landmark 2013 publication that estimated the scope of drug resistance in the United States, used better data sources to recalculate the estimates in the earlier version.
The upshot: Deaths from drug-resistant infections in 2013 were nearly double what the CDC estimated them to be at the time. Instead of 23,000 deaths, the 2013 toll is now estimated to have been 44,000.
In the interval, efforts in hospitals to limit the spread of resistant bugs among their patients have brought the number of deaths down, with the CDC now estimating 35,000 people die each year from them. That’s an 18% reduction.
The report “shows us that our collective efforts to stop the spread of germs and preventing infections is saving lives,” said the CDC’s director, Dr. Robert Redfield. “Today’s report demonstrates notable progress, yet the threat is still real. Each of us has an important role in combating it.”
The overall number of drug-resistant infections has gone up—to 2.8 million a year from 2.6 million a year in the revised 2013 figures.
Experts who reviewed the report warned that this isn’t a fight that will ever be won. The germs evolve and so does the battle to limit the damage they do to mankind. A key message of the report is that people need to stop thinking of difficult to treat or untreatable infections as a future threat.
“These are happening here and now, in the United States, in large numbers. This isn’t some developing world thing, this isn’t a threat for 2050. It’s a threat for here and now,” said Dr. Cornelius “Neil” Clancy, director of the Extreme Drug Resistance Pathogen Laboratory in the University of Pittsburgh division of infection diseases, told STAT.
The new report used electronic patient records from nearly 700 hospitals to calculate the estimates, relying on “millions and millions” of patient records, said Michael Craig, CDC’s senior adviser for antibiotic resistance coordination and strategy.
The report categorizes the impact of 18 microbial threats, from drug-resistant gonorrhea—on the urgent list—to drug-resistant Streptococcus A & B, both on the concerning threats list. Most of the pathogens—things like drug-resistant tuberculosis and Shigella, which causes diarrhea—were listed in the middle category, serious threats.
A new addition vaulted onto the list in the urgent category. Candida auris, or C. auris, is a fungal infection that is resistant to many of the available anti-fungal drugs. Its addition effectively illustrates the complexity of the problems posed by the fast-evolving field of drug resistance, Craig said.
“It’s a pathogen we didn’t even know about when we put out the last report in 2013. And since then it has circumnavigated the globe and caused a lot of infections and deaths as it has spread,” he noted.
One threat dropped off the list entirely. When vancomycin-resistant Staphylococcus aureus or VRSA was first spotted in 2002, infectious disease doctors feared what this version of Staph aureus would do to the utility of vancomycin, a potent antibiotic used in hospitals. But only 14 cases have been seen since.
The VRSA case underscores the difficulties human face in trying to combat drug-resident pathogens, said Kevin Outterson, executive director of CARB-X, a public-private partnership that is the major global funder of early stage development of drugs and other tools to fight antibiotic resistance.
There was good reason to believe VRSA would be a nightmare, Outterson said. But any companies that set off to try to address that problem would have found themselves out of sync with the needs generated by antibiotic resistance.
It proves the point that society needs to do its utmost to try to prevent and control spread of drug-resistant bugs while investing broadly to try to spur development of solutions, he said.
Lots of great research is being done, said Outterson.
“It’s not a science problem, it’s an economics problem,” he said. “Not enough money. Great science.”