A report released September 16, 2013, by the Centers for Disease Control (CDC), gives a clear picture of the burden and threats posed by antibiotic-resistant germs. The assessment was the first of its kind, and the news is not good. “If we are not careful, we will soon be in a post-antibiotic era,” Dr. Tom Frieden, the CDC’s director, said in a media briefing. “And for some patients and for some microbes, we are already there.”
Briefly, the report shows:
• Each year, in the U.S., 2,049,442 illnesses are caused by bacteria and fungi that are resistant to at least some classes of antibiotics.
• Each year, out of those illnesses, there are 23,000 deaths.
• Those illnesses and deaths cost $20 billion each year in additional healthcare spending.
• Beyond the direct healthcare costs, an additional $35 billion is lost to society in foregone productivity.
Three microorganisms were described as “urgent” threats:
(1) Carbapenem-resistant Enterobacteriaceae (CRE). This superbug kills up to half of the patients who get bloodstream infections from the disease. In addition, the CRE bacteria can reportedly transfer its resistance to other bacteria within its family. The CDC said almost all CRE infections occur in people receiving medical care in hospitals, long-term acute care facilities, or nursing homes. CDC Director Tom Frieden, M.D., M.P.H., said, “CRE are nightmare bacteria. Our strongest antibiotics don’t work and patients are left with potentially untreatable infections.” According to numbers from the CDC, almost 200 hospitals and long-term care facilities across the nation treated at least one person infected with the CRE bacteria. The CDC’s Vital Signs report said that the percentage of CRE increased by fourfold over the last decade and that one particular form of CRE, a resistant form of Klebsiella pneumonia, has increased sevenfold.
(2) Drug-resistant gonorrhea. More than 800,000 cases of this sexually transmitted disease occur annually in the United States.
(3) Clostridium difficile. Sometimes called “C diff,” this is a serious diarrheal infection usually associated with antibiotic use. It causes about 250,000 hospitalizations and at least 14,000 deaths every year in the United States.
Antibiotic-resistant infections can happen anywhere, but most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes. According to the Centers for Medicare and Medicaid Services, 27,000 nursing home residents in the U.S. have antibiotic-resistant infections.
Another study, this one published in the April issue of Infection Control and Hospital Epidemiology, found that long-term care facility residents have 8 times the risk of contracting a particular strain of E. coli compared with those not so housed. “The finding that clonal expansion of ST131 is occurring primarily in healthcare and long-term care facilities indicates an urgent need for improved antibiotic use and infection control practices within such institutions, both to reduce selection for ST131 and to block further transmission,” said Ritu Banerjee, lead investigator of the study.
According to the U.S. Department of Health and Human Services, in 2000 there were about 13 million people using long-term care services. This is expected to increase to 27 million by the year 2050. So gaining control over superbugs in such settings is an immediate imperative, both for families of loved ones in these facilities and for society as a whole.
The CDC maintains antibiotic-resistant diseases are preventable by enforcing use of infection control precautions, grouping patients with drug-resistant infections together, alerting other facilities when patients with these infections are transferred there, and using antibiotics wisely.
That may be easier said than done. Judy Stone, M.D., an infectious disease specialist, wrote in the August 14, 2013, issue of Scientific American: “My nursing home visits to do consults have shocked me. While we were careful to isolate patients within the hospital, I learned that a different set of rules applied to nursing homes. There, a patient’s room is considered their home, and they cannot legally be transferred to another room without their permission. . . . Except in extraordinary circumstances, nursing home patients cannot be confined to their rooms, as it is considered an infringement of their rights.”
If you have a family member in a long-term care facility, start a dialogue with its medical staff. Ask whether they are implementing the recommendations of the CDC for antibiotic stewardship. Do they obtain microbiology cultures prior to starting antibiotics? Do they use antibiotics only for as long as needed to treat infections, minimize the risk of relapse, or control active risk to others? Do they avoid use of antibiotics to treat viral illnesses such as colds, influenza, and viral gastroenteritis? Do the medical providers choose antibiotics with the narrowest spectrum and least cost possible? Are they keeping a clear history of patient antibiotic use?
The Louthian Law Firm is family owned and family focused. We care about your family’s health and prosperity, and we firmly believe our elderly citizens deserve the best care possible. If you fear that someone you love who now resides in a nursing home or other long-term care facility is being neglected or is the victim of medical malpractice, contact us today. We’ll join you in seeking truth and securing justice for your elderly family members. Call our toll-free number – 888-662-0434 – or our local Columbia number – 803-454-1200 – or use our confidential on-line contact form.