According to the Centers for Disease Control and Prevention (CDC), at least 2 million people in the United States each year become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of these infections.1 The Worldwide Health Organization (WHO) has said antibiotic resistance “is an increasingly serious threat to global public health that requires action across all government sectors and society.”2
This summer, the U.S. government announced the formation of a trans-Atlantic public-private partnership to combat antibiotic resistant bacteria. The objective of this global partnership, called Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator, or CARB-X, is to support the advancement of innovative products including antimicrobial therapy and preventives such as vaccines, diagnostics and devices. The first initiative identified by CARB-X will focus on antimicrobial therapy to treat Gram-negative bacteria on the Serious or Urgent Threat List prepared by the CDC.3
One specific pathogen of concern is Carbapenem-Resistant Enterobacteriaceae (CRE). Traditionally, CRE has been a problem outside of the U.S. Now, however, CRE is spreading through U.S. hospitals, particularly in long term acute care facilities. Infections associated with these organisms are linked to high rates of morbidity and mortality, and unfortunately current treatment options are limited.4
Another more recent threat identified in the U.S. is a colistin-resistant strain of the E. coli bacteria. Colistin is an older antibiotic that has resurfaced in this new era of resistance and is often considered a last resort antibiotic.5
The Centers for Disease Control and Prevention (CDC) positions antibiotic resistance as a public health threat and details the core actions needed to combat this threat, namely infection prevention, resistance tracking, antimicrobial stewardship and development of novel antimicrobials.7 Available evidence suggests that antimicrobial stewardship is associated with improved antimicrobial utilization, with corresponding improvements in antimicrobial resistance and adverse events, all without compromising clinical outcomes. Developing new drugs takes longer, however there are several initiatives in place to improve drug development, such as the 10x’20 initiative, whose aim is to create a sustainable global antibacterial drug R&D enterprise with the power in the short-term to develop 10 new, safe, and effective antibiotics by 2020.8,9,10 Of course, key elements in preventing infections from occurring in the first place include patient education around risks, providing vaccinations, practicing infection prevention and establishing infection control departments.
Stay tuned for our next article, where we’ll expand on the new antimicrobial stewardship requirements coming in 2017 and discuss resources that will help you reach compliance.
1Centers for Disease Control
2 World Health Organization
3 Wall Street Journal, U.S. to Form International Partnership to Fight 'Superbugs'
4 CDC, https://www.cdc.gov/hai/organisms/cre/
5 Washington Post, https://www.washingtonpost.com/news/to-your-health/wp/2016/07/11/superbug-gene-detected-in-a-second-person-in-the-u-s/
7 Untreatable Report, CDC http://www.cdc.gov/drugresistance/threat-report-2013/
10 CDC, http://www.cdc.gov/drugresistance/federal-engagement-in-ar/