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Resistance — Not All Germs Are Created Equal

Antibiotic resistance has become a major threat to public health worldwide, and the primary cause for this man-made epidemic is the widespread misuse of antibiotics — drugs used to combat bacterial infections in humans and animals. Over the decades, antibiotics have been widely overprescribed for infections that don't respond well, or at all, to these drugs. 

Viral infections, for example, cannot be treated with antibiotics since they only kill bacteria, yet many of you have likely taken a course of antibiotics for an ear infection, or a bout of cold or flu. Antibiotics have also been routinely used for growth promotion purposes in livestock, and this practice continues in the U.S. to this day, despite the well-known risks. 

In the U.S. alone, antibiotic-resistant pathogens are conservatively estimated to cause at least 2 million infections annually, leading to 23,000 deaths each year. Data1,2 from the European Union show there's been a significant rise of resistance to multiple antibiotics in Klebsiella pneumoniae and E. coli. 

An estimated 25 to 60 percent of K. pneumoniae featuring in bloodstream infections are now resistant to several different antibiotics, making these infections extremely difficult to treat. The rise in pan-resistance (resistance to multiple drugs) in turn has led to a significant increase in use of carbapenems — a class of last-line antibiotics. Disturbingly, carbapenem-resistant Enterobacteriaceae are also rapidly becoming more common in hospitals,3 and an estimated 1 in 25 patients now end up with a hospital-acquired infection.

The Rise of Antibiotic Resistance

The featured 2015 documentary, "Resistance,"4 delves into the history of bacteria, antibiotics and the subsequent development and spread of antibiotic resistance. It also features personal stories of people impacted by drug-resistant infections. Not surprisingly, those affected generally feel we've squandered an awesome resource by overusing antibiotics, thereby creating bacteria that are impervious to these drugs.

For years now, scientists have warned we are entering a pre-antibiotic era once more, where infections that were once simple to treat will become deadly. Already, drug-resistant urinary tract infections (UTIs) and tuberculosis are on the rise, as are several sexually transmitted diseases. For example, the two main strains of syphilis in circulation worldwide have developed resistance to azithromycin, the second drug of choice for this infection.5,6

The Street Strain 14 (SS14), which is a newer strain, appears to be far more drug-resistant than the older Nichols strain. A whopping 90 percent of the SS14 samples had drug resistance genes. There's also evidence showing the three most common STDs — chlamydia, gonorrhea and syphilis — are all developing pan-resistance.

Gonorrhea is already resistant to all antibiotics that have been used against it, and is rapidly developing resistance against cephalosporins, the drug of last resort. In the case of UTIs, drug-resistant infections have actually been traced back to the consumption of chicken contaminated with antibiotic-resistant E. coli. As more and more antibiotics become useless, surgeries will also become life-threatening events, and organ transplants may become virtually impossible. 

Efforts to Scale Back Human Consumption of Antibiotics Have Failed

Between 2000 and 2015, the global human consumption of antibiotics rose by 65 percent, reaching 42 billion doses a year.7 The increase was driven by low- and middle-income countries and, if no policy changes are made, it's estimated that global antibiotic consumption will rise up to 200 percent higher by 2030.

Use of antibiotics in high-income countries still remains higher than in most low- and middle-income countries, but their use is rising fast — a concern, in part, because antibiotics are often available without a prescription in lower-income countries, making the potential for abuse high. 

In the U.S., while rates of antibiotics didn't rise sharply, they also didn't fall, which suggests efforts to scale back inappropriate usage have largely failed. Lance Price, director of the Antibiotic Resistance Action Center at George Washington University, recently told NPR:8

"The biggest driver for the evolution of superbugs is the use of antibiotics … The more we use antibiotics, the more we are going to encourage the growth of these bacteria that are resistant to them … [Already] you have these extreme cases like the woman [in Nevada] just about a year ago who died of an infection that was resistant to 26 different antibiotics … So, bacteria are out there that are resistant to everything, and they are becoming more and more prevalent."

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