Biggest Threats
In 2013, CDC published a report outlining the top 18 drug-resistant threats to the US. These threats were categorized based on level of concern, as being:
Urgent Threats: Clostridium difficile (C. Diff), Carbapenem-Resistant Enterobacteriaceae (CRE), Neisseria gonorrhoeae.
Serious Threats: Multidrug-Resistant Acinetobacter, Drug-Resistant Campylobacter, Fluconazole-Resistant Candida, Extended Spectrum Enterobacteriaceae (ESBL), Vancomycin-Resistant Enterococcus (VRE), Multidrug-Resistant Pseudomonas aeruginosa, Drug-Resistant Non-Typhoidal Salmonella, Drug-Resistant Salmonella Serotype typhi, Drug-Resistant Shigella, Methicillin-Resistant Staphylococcus aureus (MRSA), Drug-Resistant Streptococcus pneumoniae, Drug-Resistant Tuberculosis.
Concerning Threats: Vancomycin-Resistant Staphylococcus aureus, Erythromycin-Resistant Group A Streptococcus, Clindamycin-Resistant Group B Streptococcus.
I have to admit that I am seriously concerned with this attitude and approach by the federal government and all of its major healthcare agencies: If the "threat-specific CDC activities are tailored to meet the epidemiology of the infectious agent and to address any gaps in the ability to detect resistance and to protect against infections," where then are their "threat-specific CDC activities tailored" to treat infections, once a subject is infected. This job is then left to clearly underfunded academic researchers, to the R&D budget of the pharmaceutical industry, or to the entrepreneurial efforts of the biotech industry; I'll bet on the latter.
World Health Organization (WHO): Deaths attributable to AMR (Anti-Microbial Resistance) every year compared to other major causes of death. Jim O'Neill Chairman of the Review on Antimicrobial Resistance.
Similarly, the CDC (Centers for Disease Control and Prevention, Atlanta, GA) fails to emphasize the urgent need to discover and develop new antibiotics, most especially for the treatment of antibiotic-resistant infections. In CDC's 'National Strategy to Combat Antibiotic-Resistant Bacteria,' they define Antibiotic-Resistant Bacteria as, 'Germs that don't respond to the drugs developed to kill them - threaten to return us to the time when simple infections were often fatal.'
Today, antibiotic-resistant bacteria annually cause at least 2 million illnesses and 23,000 deaths in the US. Detecting, preventing and controlling antibiotic resistance requires coordinated efforts. To support the President's Executive Order and the White House's National Strategy to Combat Antibiotic-Resistant Bacteria[PDF - 37 pages], CDC is working to address the threat in these four areas:
- Slow the development of resistant bacteria and prevent the spread of resistant infections.
- Strengthen national one-health surveillance efforts to combat resistance.
- Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria.
- Improve international collaboration and capacities for antibiotic resistance prevention, surveillance, control and antibiotic research and development.
Clearly, it is only at the end of the last bulleted item above do we find any mention of the need or interest in 'antibiotic research and development.' In all cases, our healthcare agencies and the pharmaceutical industry fail to address the immediate and longer-term challenges of discovering and developing new antibiotics for the treatment of resistant infections; we have work to do.
Consider, as well, that we as a population seem to be unable to control new infections in hospital or community settings, the emergence of new strains of resistant infectious agents, or new forms and mechanisms of resistance, most especially while we continue to engage municipal wastewater treatment plants as natural incubators for the development of antibiotic resistance.
The video below shows our local approach to developing new and continuing antibiotic resistance, simply because we have failed to figure out how best and safely to dispose of our toxic and infectious sewage sludge. The video is from this week, and records a short walk through one local forest and wetlands that are disposal points for our sewage sludge. Go figure!
https://vimeo.com/127311446 Password: Precaution1
0 comments