With descriptions like “nightmare bacteria” and “deadly superbug”, reports surrounding the recent exposure to carbapenem-resistant Enterobacteriaceae (CME) in Los Angeles are understandably alarming, especially considering almost 200 UCLA Medical Center patients may have come in contact with such a bug.
This exposure and resulting infections raise many questions: Will more patients become infected? What will become of the medical devices implicated? How worried should we realistically be?
If more and stronger action isn’t taken soon to address the growing issue of superbugs like CRE, reports suggest we could face serious consequences: By 2050, these infections could kill 10 million people worldwide — more than all types of cancer, combined.
With that in mind, here are eight things you should know about the emerging global threat:
1. What does the term “superbug” actually mean?
It’s not exactly a medical term, but colloquially it’s come to represent a class of dangerous microbes, generally bacteria, that have mutated in a way that help them to resist the medications we most frequently use to treat them. This is why superbugs are also often referred to as drug-resistant or antibiotic-resistant. They’ve spawned the ability to outsmart our best line of defense against the infections they cause.
2. What causes them to mutate like that?
Like any living organism, bacteria can mutate as they multiply. Also like any living organism, bacteria have a strong evolutionary drive to to survive. So, over time, a select few will mutate in particular ways that make them resistant to antibiotics. Then, when antibiotics are introduced, only the bacteria that can resist that treatment can survive to multiply further, proliferating the line of drug-resistant bugs.
3. Why are we hearing more about superbugs now?
Infections with superbugs are on the rise nationwide and around the globe. At least 2 million people become infected with antibiotic-resistant bacteria a year in the U.S., and an estimated 700,000 die from such an infection worldwide. Without additional methods of treating superbugs, that number could reach 10 million by 2050. One recent study found that the number of CRE infections in the U.S. increased by 500 percent from 2008 to 2012. Globally, there has been such a sharp increase in drug-resistant microbes over the past two decades that the World Health Organization (WHO) recently declared the issue a global public health crisis, warning, “The problem is so serious that it threatens the achievements of modern medicine.”
4. Who is most at risk?
Drug-resistant infections are more common in hospital or other health-care settings. People who are already seeking medical attention may have weakened immune systems that leave them more susceptible to infections. To date, CRE infections have been observed almost exclusively within healthcare settings, but since Enterobacteriaceae spread easily in the community, experts say the potential for widespread CRE transmission must be considered. Several other superbugs have already made their way outside of hospitals and into the community. MRSA, for example, one of the most well-known drug-resistant superbugs, is on the decline overall, but transmission is actually increasing outside of hospitals. It’s important to keep in mind that infection is a possible risk of any surgical procedure, but only occurs in about 1 percent of cases.
5. What can I do to protect myself?
Since there are limited treatment options (because these infections are resistant to antibiotics), prevention is the best measure. The Centers for Disease Control and Prevention (CDC) urge patients concerned about drug-resistant infections to stay up-to-date on vaccines, which will help you stay healthier overall and out of medical facilities in general. Careful hand-washing in a hospital setting should be a regular practice. But perhaps most importantly, you can avoid unnecessary treatment with antibiotics. Taking antibiotics when they are not needed can up your risk of drug-resistant infection down the line, according to the CDC, which estimates that antibiotics are “not optimally prescribed” as much as 50 percent of the time. Remember: Antibiotics do not fight viruses, so don’t try to talk your doctor into writing you a prescription when you have the flu. And when you do need to take antibiotics, make sure you always take them as prescribed — don’t skip doses and be sure to finish the entire course of treatment, even if you’re feeling better.
6. What about developing new antibiotics?
Despite dire warnings about the growing number of untreatable drug-resistant infections, there has been very little progress towards developing new antibiotics over the past decade. Currently, only seven new drugs are in development for the treatment of these superbugs — far less than any other class of medications. One reason for the lack of progress is that it isn’t as profitable for pharmaceutical companies to invest in creating new drugs as it is to produce existing drugs. Last year, the U.S. government formed a partnership with a large pharmaceutical company in an effort to spur innovation, and infectious disease experts are urging Congress to pass tax credits to encourage the development of new antibiotics. But health officials say developing more antibiotics will not solve the problem on its own — eventually, bacteria will become resistant to them, too. That’s why proper antibiotic use and disease prevention strategies are considered key to slowing drug resistance.
7. Are some superbug infections more serious than others?
Yes. The CDC lists three urgent threats: CRE, responsible for about 9,000 infections a year, C. difficile, which causes about 250,00 cases of life-threatening diarrhea a year, and neisseria gonorrhoeae, which causes around 246,000 cases of drug-resistant gonorrhea a year. These most critical concerns are followed by 12 slightly less serious threats that are expected to worsen, however, including bacteria that cause diarrhea, meningitis, tuberculosis, blood infections and more. The list of drug-resistant infections is increasing at a rapid rate, so new threats are constantly emerging. Already, in some areas of the world, antibiotics used to treat common ailments like pneumonia don’t work in over half of infected people, according to the WHO’s landmark 2014 global report on antibiotic resistance. Rates of resistance to treatment among bacteria that cause some of the most common serious infections are “very high,” and in all regions of world, hospitals are reporting “untreatable or nearly untreatable” infections, the WHO report stated.
8. Should I be concerned about antibiotics in food?
Yes — the germs that contaminate our food can also become drug-resistant. It is estimated that 70 percent of all antibiotics are used in farming, generally to make animals gain weight quickly, which could contribute to growing antibiotic-resistance. In fact, a particular strain of drug-resistant E. coli seems to be causing more urinary tract infections than in the past, and some researchers believe chickens are the source. Eating chicken carrying drug-resistant E. coli delivers the bacteria to a person’s gut and could eventually end up causing an infection — and indeed, studies show genetic similarities between the E. coli found in chicken and in people with UTIs, Everyday Health reported. Others argue this E. coli could originate in humans but make its way to animals through the sewage system. Meanwhile, another recent study demonstrated that antibiotic resistant bacteria can be transmitted from animals on the farm to humans through the air.