The most fascinating and terrifying thing about biology is evolution. In particular, even the most minute viruses and bacteria can evolve to resist the most modern and carefully crafted antibiotics, leading to 2 million new infections a year and 23,000 deaths.
The U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threats the nation faces from antibiotic-resistant organisms, and interestingly, the threats don't stop at "death." In fact, these little bacteria are ranked by "how much and how imminent a threat they pose, using seven criteria: health impact, economic impact, how common the infection is, how easily it spreads, how much further it might spread in the next 10 years, whether there are antibiotics that still work against it, and whether things other than administering antibiotics can be done to curb its spread."
In a press briefing about his recent research, Dr. Tom Frieden, the CDC's director, warned "If we are not careful, we will soon be in a post-antibiotic era … And for some patients and for some microbes, we are already there." The confidence in his statement reflected the very first hard numbers for the incidence, deaths, and cost of all the major resistant organisms gathered by the CDC.
The urgent worry gripping national health organizations like the CDC is that our current "gaps in knowledge" and continued inadvertent strengthening of antibiotic-resistant bacteria could lead to the evolution of new vicious, contagious diseases with no current ways to combat them. Various reports have outlined the call to action in four areas: "gathering better data; preventing infections, through vaccination, better protective behavior in hospitals, and better food handling; improving the way in which antibiotics are used, by not using them inappropriately in health care or agriculture; and developing not just new categories of antibiotics but better diagnostic tests so that resistant organisms can be identified and dealt with sooner, before they spread."
Frieden added his perspective on the medical front. "My biggest frustration is the pace of change … Hospitals are making progress, but … the challenge is scaling up what we know works, and doing that fast enough so that we can close the door on drug resistance before it's too late."
Dr. Ed Septimus, a professor of internal medicine at Texas A&M Health Sciences Center in Houston, also recognized the power of political progress regarding the issue, specifically mentioning the GAIN Act which offers incentives for drug development, and the STAAR Act which, although failed legislation, is aimed at improving disease surveillance and antibiotic conservation.
Most importantly however, and likely the most direct way the consumer could impact their own health, is the relationship between antibiotic use in agriculture and resistant infections in humans. Observations by the CDC have not only prompted individuals, but policymakers as well of how they can potentially curb the risks posed by mechanized agricultural practices, while respecting the role of animals, farming economics, and the need to mass produce food for the growing population.
Ultimately, antibiotic resistance will only continue to increase unless long term methods focused on widespread engagement can gauge the interest of leaders in clinical medicine, health care leadership, agriculture, and public health.