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Antibiotic-Resistant Infections Lead to 23,000 Deaths a Year, C.D.C. Finds

Sterile Environments’ Medical Advisory Board Member, Dr. Eli Perencevich is quoted in this very important N.Y. Times article:

Federal health officials reported Monday that at least two million Americans fall ill from antibiotic-resistant bacteria every year and that at least 23,000 die from those infections, putting a hard number on a growing public health threat. It was the first time that federal authorities quantified the effects of organisms that many antibiotics are powerless to fight.

The number of deaths is substantially lower than previous estimates, in part because researchers from the Centers for Disease Control and Prevention stripped out cases in which a drug-resistant infection was present but not necessarily the cause of death. Infectious disease doctors have long warned that antibiotic resistance — in which bacteria develop defenses against antibiotics used to kill them — threatens to return society to a time when people died from ordinary infections.

Dr. Steven L. Solomon, the director of the C.D.C.’s office of antimicrobial resistance, acknowledged that the report underestimated the numbers, but said that was by design. Researchers were instructed to be conservative and to base their calculations only on deaths that were a direct result of a drug-resistant bacterial infection.

“This is a floor,” Dr. Solomon said. “We wanted the cleanest number, the least subjective number.”

Infections from one of the most pervasive types of drug-resistant bacteria tracked in the report, MRSA, have been declining. Invasive MRSA infections in hospitals went down by more than half from 2005 to 2011, according to a paper published Monday in the journal JAMA Internal Medicine. However, the number of invasive MRSA infections picked up outside health care settings has not changed much, and researchers pointed out that the number of those types of infections has for the first time outstripped the number acquired in hospitals.

“This is a really big switch,” said Eli Perencevich, an infectious disease epidemiologist at the University of Iowa.

Hospitals have taken steps to prevent drug-resistant infections, but less is known about preventing infections outside hospitals, clinics and nursing homes.

The 114-page report counts infections from 17 drug-resistant bacteria and one fungus, pathogens that Dr. Solomon said caused an overwhelming majority of drug-resistant bacterial infections in the country. It drew on data from five disease-tracking systems, including a major count of bacterial infections reported in hospitals in 10 different areas across the country. The count of deaths was based on mathematical models — one for each resistant organism.

One particularly lethal type of drug-resistant bacteria, known as CRE, has become resistant to nearly all antibiotics on the market. It is still relatively rare, causing just 600 deaths a year, but researchers have identified it in health care facilities in 44 states.

“We are getting closer and closer to the cliff,” said Dr. Michael Bell, a C.D.C. official who presented the data.

Courtesy: N.Y. Times, September 2013

 

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