Antibiotics, the miracle drugs invented in the mid-20th century, have made possible a revolution in modern medicine — for example, enabling organ transplants — and have spared countless individuals from death and illness. When bacteria became resistant in the early years, new antibiotics were readily created. But more recently, the pipeline of antibiotic development has slowed, and patients are again confronting untreatable illnesses.
The CDC knew this when it estimated in 2013 that 2 million Americans had suffered antibiotic-resistant infections resulting in 23,000 deaths a year. But using improved data methods, the CDC has now revised the estimates to 2.6 million infections then, and 44,000 deaths, nearly twice as many as thought. Today, the agency says there are 2.8 million infections and 35,000 deaths a year. The number of deaths due to antibiotic-resistant infections has dropped by 18 percent, according to the CDC, largely because of successful interventions by hospitals. That’s the good news.
But there is plenty to worry about. Though hospitals are making headway, the agency found some of the greatest increases in infections are acquired outside hospitals. Also, the threat of antibiotic resistance is remarkably fluid; new threats arise even as old ones are mitigated. For example, the CDC has raised the alert level to “urgent” for Candida auris, a multi-drug-resistant yeast that can cause invasive infection and death. Some strains are resistant to all three available classes of antibiotics. It wasn’t even listed in the 2013 report, but the CDC says reported cases have surged 318 percent in 2018 compared with 2015 to 2017. The CDC has also raised the alert level to “urgent” for strains of Acinetobacter that are resistant to carbapenems, a class of highly effective antibiotics. Also concerning: Gonorrhea, a sexually transmitted disease, has rapidly become resistant to all but one class of antibiotics.
The CDC has put a welcome and needed emphasis on fighting antibiotic resistance as a “one health” problem that is interconnected between human and animal health, and the environment. Big challenges remain, including being vigilant against overuse of antibiotics and creating an improved model for developing new antibiotics. There is no excuse for inaction. The threats are real, dynamic and persistent.