Superbugs’ deadly rise has plunged planet into risky ‘post-antibiotic’ era

clostridioides_difficile_369x285-300x232Federal officials have put out some scary new findings about the state of patients’ health in the 21st century: Superbugs may be more common and potent than previously believed. And we may now have plummeted into what experts are calling the perilous “post-antibiotic age.”

This all amounts to far more than a hypothetical menace. It could affect you if you get, for instance, a urinary tract infection. Or if you undergo a surgery, say, for a joint replacement or a C-section. Depending where and how you live, you may see the significance of this health problem if you contract tuberculosis or some sexually transmitted diseases.

As the news website Vox reported of the startling new information from the federal Centers for Disease Control and Prevention: “Every 15 minutes, one person in the U.S. dies because of an infection that antibiotics can no longer treat effectively.”

The Washington Post described the toll of so-called superbugs — aka antibiotic resistant bacteria and fungi — thusly:

“Drug-resistant germs sicken about 3 million people every year in the United States and kill about 35,000, representing a much larger public health threat than previously understood, according to a long-awaited report released Wednesday by the Centers for Disease Control and Prevention. The new estimates show that, on average, someone in the United States gets an antibiotic-resistant infection every 11 seconds …Bacteria, fungi and other germs that have developed a resistance to antibiotics and other drugs pose one of the gravest public health challenges and a baffling problem for modern medicine. Scientists, doctors and public health officials have warned of this threat for decades, and the new report reveals the top dangers and troubling trends. More pathogens are developing new ways of fending off drugs designed to kill them, and infections are spreading more widely outside of hospitals. No new classes of antibiotics have been introduced in more than three decades.”

In the new CDC report, Dr. Robert Redfield, the agency’s director, says this: “Stop referring to a coming post-antibiotic era—it’s already here. You and I are living in a time when some miracle drugs no longer perform miracles and families are being ripped apart by a microscopic enemy.”

Because America has the richest health system in the world, one that is more prone than any other to prescribing antibiotics and pills, the superbug nightmare may be the most severe. But the over use and increasing failure of infection-killing drugs is not confined to our shores, as Vox reported, adding: “700,000 people around the world die of drug-resistant diseases each year. And if we don’t make a radical change now, that could rise to 10 million by 2050.”

Experts at the RAND Corporation have estimated that unchecked, antibiotic resistance could reduce the global population by up to 444 million people and that could contribute to global economic losses as high as $124.5 trillion.

CDC officials reported a sliver of hopeful news, too, about antibiotic-resistant bugs, as the New York Times noted:

“The agency documented a 30% decline in deaths among patients who acquire drug-resistant infections in hospitals, a reduction it attributed to better hygiene among nurses and doctors who in recent years have been bombarded with messages about the importance of hand washing.”

Still, as the newspaper added:

“Among the greatest threats the report cites are a form of drug-resistant gonorrhea that has been spreading among young people and gay men, tough-to-treat urinary tract infections that strike otherwise healthy women, and Clostridioides difficile, or C. diff [shown in photo above], a deadly bacterial infection that ravages the guts of hospitalized patients, sickening 224,000 and killing 12,800 each year.”

New York state, the newspaper reported, took a new step in battling superbugs by becoming “the first state to release the names of the medical facilities that have treated patients with Candida auris, a fungus that is resistant to major medicines and has been spreading globally under a cloak of secrecy.” As the news organization reported:

“ C. auris is one of the newer and more mysterious examples of such infections. The New York Times has spent the past year documenting its rise as multiple governments declined to identify or confirm the names of hospitals and nursing homes with the presence of C. auris. Some hospitals, including major academic institutions, declined to discuss cases even when family members or physicians confirmed them. New York health officials said they decided to break with that practice and disclose the names of the institutions with cases in the state over the past three years because of how rapidly C. auris has spread. Their aim, they said, was to provide transparency to consumers and encourage hospitals and nursing homes to help stop its spread.”

Quashing superbug outbreaks may be one of several steps to deal with antibiotic resistance, experts say. They also have urged doctors and patients to halt the indiscriminate use of the drugs, with prescriptions, for example, for common colds or ear infections whose viral causes aren’t helped by antibiotics. Individuals can help reduce infections’ risks by staying healthy, by eating well, getting enough exercise and sleep, controlling their weight and alcohol use, and not smoking. They also should consider keeping their vaccinations up to date, including for the flu.

Big Agriculture also must be discouraged from abusive antibiotic use on crops and with livestock to increase yields. Major food customers — including fast food and restaurant chains and schools and governments — can encourage their suppliers to forgo wasteful and unnecessary antibiotic use.

Big Pharma could play a beneficial role in developing and selling bug fighting drugs at reasonable costs. Profit-ravenous makers, however, have deigned to tackle a global need that would serve humanity — because the returns would be too low, and the risks would be high. Nonprofits and health agencies may need to step in on a global basis to address this and other looming crises with pharmaceuticals, just as the World Health Organization has acted to attack profiteering and soaring prices for lifesaving insulin.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the common sense in their working to stay healthy and out of the health care system. That system not only is costly and inconvenient, it is proving to be all too risky, rife with medical error, hospital infections and deaths, and misdiagnoses.

It’s small cause for hope, as the CDC noted, that antibiotic over use and super bug infections may result in fewer deaths, even as the nation tallies more cases. But this is faint praise. It has been decades since a blue-ribbon panel, weighing tons of evidence, called on the nation’s hospitals to better serve their patients and communities by applying rigorous evidence and best practices to improve the quality and safety of their care. Hospitals have feasted on giant profits in the years since, even as key and sometimes basic measures of their improving patient care barely move.

As the nation grays and more Americans spend increasing time, too, in nursing homes and skilled nursing facilities, it is becoming clear that politicians and regulators may need to ramp up their oversight of these costly facilities. They can’t become warehouses for frail, debilitated, and over medicated seniors — too many of whom, in effect, may be serving, tragically, as superbug incubators. My colleagues and I seek to assist patients and loved ones injured by nursing home abuse and neglect, and scenarios where infections flourish in these facilities is unacceptable.

How urgent is the need for stepped up oversight in health care, notably nursing homes? In California, federal officials took proactive action as the state’s deadly wildfire season began. They decided to conduct spot checks on nursing homes to see if they were prepared with lifesaving measures, if needed, to ensure the safety and quality of their patients’ care even under emergency conditions. As the Kaiser Health News Service reported of investigators’ unhappy findings:

“The results of their surprise inspections, which took place from September to December of 2018, were disturbing: Inspectors found hundreds of potentially life-threatening violations of safety and emergency requirements, including blocked emergency exit doors, unsafe use of power strips and extension cords, and inadequate fuel for emergency generators, according to a report … by the U.S. Department of Health and Human Services Office of Inspector General. The nursing home residents ‘were at increased risk of injury or death during a fire or other emergency,’ the report concluded. The threat is not theoretical in a state that has been ravaged by natural disasters: One of the nursing homes that was inspected burned down in a wildfire afterward, so the report only includes results for the 19 remaining facilities, which it does not identify.”

We’ve got a lot of work to do to stamp out antibiotic abuse, superbug infections, and poor quality and unsafe treatment of patients in hospitals and nursing homes.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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