In a comprehensive report on antibiotic-resistant superbugs, the US Centers for Disease Control and Prevention (CDC) doesn’t shy away from terms like “nightmare”, but its analysis is not completely pessimistic. The takeaway? It’s not too late to combat the emergence of new microbial threats.
“We talk about the pre-antibiotic era and antibiotic era,” says CDC director Thomas Frieden. “If we’re not careful, we will soon be in a post-antibiotic era.”
Every year in the US, 2 million people are infected with bacteria resistant to at least one antibiotic, and 23,000 people die from those infections. In addition, Clostridium difficile, a hospital-acquired infection that is often caused by antibiotic use, afflicts another 250,000 Americans.
Much of the antibiotic resistance that has emerged is a product of poor prescribing practices by physicians, the CDC says. It estimates that up to half of all antibiotic prescriptions do not meet current guidelines for antibiotic use.
The agency’s report recommends four core strategies to limit antibiotic resistance: working to prevent infections, improving the tracking of antibiotic-resistant infections, making judicious use of antibiotics and developing new drugs and diagnostic tests. For much of the past century, society has taken the creation of new antibiotics for granted. Without any new drugs in the immediate pipeline, however, better policies are now the key to combating resistance to existing antibiotics.
The CDC also ranked drug-resistant bacteria by the threat they pose. The agency’s list of 18 bugs is topped by C. difficile, carbapenem-resistant Enterobacteriaceae and drug-resistant gonorrhea (Neisseria gonorrhoeae), all considered ‘urgent’ threats. The complete ranking of antibiotic-resistant bacteria threats is below.
- Clostridium difficile
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Drug-resistant Neisseria gonorrhoeae
- Multidrug-resistant Acinetobacter
- Drug-resistant Campylobacter
- Fluconazole-resistant Candida (a fungus)
- Extended spectrum β-lactamase producing Enterobacteriaceae (ESBLs)
- Vancomycin-resistant Enterococcus (VRE)
- Multidrug-resistant Pseudomonas aeruginosa
- Drug-resistant Non-typhoidal Salmonella
- Drug-resistant Salmonella typhi
- Drug-resistant Shigella
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Drug-resistant Streptococcus pneumoniae
- Drug-resistant tuberculosis
- Vancomycin-resistant Staphylococcus aureus (VRSA)
- Erythromycin-resistant Group A Streptococcus
- Clindamycin-resistant Group B Streptococcus