A report issued in November by the Centers for Disease Control and Prevention (CDC) revealed some bad news and some good news about infections caused by antibiotic-resistant microbes, or superbugs, in America. Superbugs are germs such a bacteria and fungi that can’t be destroyed by the medications currently available to fight them.

First, the bad news: In the report, the CDC noted that antibiotic-resistant superbugs have killed nearly twice as many people as previously believed. Also, the CDC announced it has identified two new, potentially deadly superbugs, bringing the total of most threatening superbugs to five.

One of the new superbugs,, a fungus called Candida auris, was a bit of a surprise to CDC officials. Five years ago, they weren’t even considering Candida auris as a serious threat. But it is now.

Among the superbugs we’ve known about, C difficle is a particularly nasty one. It is considered an urgent threat by health officials. C difficle alone caused nearly 250,000 infections in 2017, the most recent year for available data. It also caused at least 12,000 deaths that year.

The good news is that the total number of deaths from superbug infections has declined by 18 percent. The CDC estimates that 36,000 Americans died as a result of superbug infections in 2017. Compare that to 44,000 deaths in 2013. The decline is attributed, at least in part, to more judicious prescribing of antibiotics by physicians.

Antibiotic resistance is considered one of the world’s most pressing health problems. It happens when the germs find a way to survive the onslaught of death caused by the drugs. Bacteria are sneaky. They can alter antibiotics’ effect on them in several ways. I’ll describe a few of those ways soon.

Just to be clear, it’s the bacteria that become resistant to the medications. Individuals don’t become resistant. But resistant germs can be spread from person to person, and before you know it, an entire community is at risk.

So how do germs become resistant to antibiotics? The short answer is: They fight back!. They develop defense strategies called resistance mechanisms. Bacteria develop these mechanisms by altering the coded instructions found in their DNA. They can then share altered pieces of their DNA with other germs, making them resistant as well.

One of the resistance mechanisms bacteria use is to restrict the access of the antibiotics. Bacteria do this by changing or limiting the entryways for the antibiotics into their cells. That way, the drugs can’t get inside the bacteria to destroy them.

A second defense strategy of bacteria is to rid themselves of the antibiotic. They use pumps located in their cell walls to pump out any antibiotic that gets into the cells. A third strategy is to change or destroy the antibiotic using enzymes and proteins that break down the medication, rendering it useless.

Many antibiotics are designed to single out and destroy specific parts of a bacterium. These are the medications’ targets. One resistance mechanism is to bypass the effects of the antibiotics by developing new cell processes that avoid using the antibiotics’ targets.

Bacteria also develop resistance by changing the antibiotics’ targets. As a result, the antibiotics no longer fit and the drugs can’t do their job of destroying the bacteria.

The CDC and the World Health Organization continue to call on physicians to prescribe antibiotics only when they’re absolutely necessary and appropriate to treat patients’ infections. They ask us to take action as well to use antibiotics wisely. Here are a few suggestions for things you can do:

• Don’t pressure your doctor to prescribe an antibiotic for a viral infection such as a cold or the flu. Antibiotics aren’t effective on viruses. Ask your doctor about other ways to treat your viral infection.
• Don’t save antibiotics you didn’t use for the next time you get sick. Discard any medication that’s left over once you’ve completed your prescribed course of treatment.
• Take your antibiotics exactly as your doctor prescribes. Don’t skip doses, and be sure to take the medication until it’s gone. For it to be most effective, you must take the medication for the entire time of your treatment .You may start to feel better and think you don’t need the medication anymore, but take it for the full course anyway. Some germs may survive the antibiotics’ initial effect and re-infect you if you stop too soon.
• Don’t take someone else’s antibiotics. They may not be right drugs for your type of infection. Taking the wrong antibiotic can delay your treatment and allow the bacteria to multiply.

The world has a drug problem! It’s getting so bad that the United Nations held a special meeting last September to discuss it – only the fourth time ever the UN called a high-level meeting on a global health issue.

This time, the delegates discussed antibiotic-resistant infections, the superbugs impervious to our current arsenal of germ-fighting drugs.

Drug-resistant bacteria, as well as drug-resistant parasites, viruses and fungi, have been lurking for a while. One superbug has been popping up, even here in the US, that is resistant to our last-ditch antibiotic. Without medications that can fight these germs, there will be untreatable infections that will have devastating consequences across the globe.

Already, it’s estimated that more than 700,000 people worldwide die each year from drug-resistant infections. And that’s a lowball figure because tens of thousands of deaths from these infections are not reported or are attributed to other causes. One review of the problem suggests that by 2050, 10 million people around the world will die each year from these infections.

Drug resistance happens naturally over time, usually through genetic changes. However, the overuse and misuse of antibiotics and other drugs developed to treat microbial infections has accelerated this process. Using antibiotics for every little illness, especially for viral infections such as colds and flu, and for promoting growth in livestock, are examples of this misuse. After years of doing this, we now have a resistance problem.

One superbug that’s got everybody scrambling is a bacterium that can’t be killed by the drug of last resort, Colistin. Infections with this bacteria had been seen in animals and humans in China and Europe, but have been discovered in the US as well. Fortunately in those cases, the infections responded to other antibiotics, but the bacteria’s resistance to Colistin is significant.

Why? Without getting too technical, the genetic change that makes this bacteria resistant to Colistin can be spread to other strains of bacteria. They include strains already resistant to all other antibiotics except Colistin. Spread of the genetic change could create new mutations that are totally untreatable with any drug currently available.

With superbugs like these, routine medical procedures such as C-sections, hip replacements and chemotherapy become extremely high risk. Without effective antibiotics to treat them, minor infections could become life-threatening crises. Little, if anything, could be done to treat common conditions such as gonorrhea and pneumonia.

What can be done? At the UN meeting in September, World Health Organization director general Margaret Chan stressed that it is imperative for consumers and medical providers to rely less on antibiotics for disease treatment. She also appealed for more progress in antibiotic development. After all, only two new classes of antibiotics have reached the market in the past half-century.

As they brought the meeting to a close, the UN delegates signed a declaration committing to encouraging innovation in antibiotic development and increasing public awareness of the growing threat of drug-resistant infections. They also agreed to develop surveillance and regulatory systems on the sales and use of antimicrobial medicines for humans and animals.

Facing a new kind of drug problem, the world is poised to take on the challeng

It’s funny how things happen sometimes. When Alexander Fleming woke up the morning of September 28, 1928, he had no idea he would discover the first commercially available antibiotic – penicillin. After the antibiotic was isolated and purified, it came into wide use during World War II.

When accepting the Nobel Prize for his discovery in 1945, Fleming warned of bacteria becoming resistant to penicillin. More than 70 years later, his warning message has become a reality – in spades.

When it was introduced, penicillin was considered a “miracle drug” because it saved lives from previously deadly infections. Since its discovery, additional antibiotics have been developed that fight off increasingly stubborn and hard-to-treat strains of bacteria.

Unfortunately, the overuse and improper use of these life-saving medications over time have created a serious problem across the globe. Some of the worst bacteria have developed resistance to the available drugs, creating a race of “superbugs.”

These superbugs lead to significant health complications. According to the US Department of Health and Human Services, more than two million illnesses and 23,000 deaths each year in the United States are related to antibiotic resistance. The World Health Organization (WHO) reports deadly drug-resistant superbugs also kill 25,000 Europeans each year.

Everyone is at risk for infection by a superbug, but there are some people who are more susceptible. These include patients, especially older patients, in hospitals and nursing homes, and people with compromised immune systems, such as transplant recipients and those receiving chemotherapy.

Superbugs were bound to develop, considering the extensive antibiotics prescribed in health care. Unfortunately, in up to 50 percent of those cases, the drugs were not optimally prescribed, often used when not appropriate or in the wrong dosage or for the wrong length of time.

Also, antibiotics are often given to animals like pigs and cows to promote their growth. Traces of these drugs can remain on the animals after they are butchered and find their way into humans through their food, further exposing them to non-essential antibiotics.

People are getting all these antibiotics, but they also get exposed to a lot of bacteria, including strains that are already drug-resistant – the superbugs. These can be spread various ways, including from person-to-person and by contact with contaminated sources in the environment.

How does resistance develop? People typically have a lot of bacteria in their bodies. When they are given antibiotics, the drugs kill off any germs, but also kill the good bacteria in their systems. Any bacteria resisting the drugs are now able to thrive. What complicates things is some resistant bacteria can spread their resistance to other strains by sharing small pieces of DNA. As a result, superbug growth explodes.

Health care professionals are now aware of the superbug crisis, and most have become more prudent about prescribing antibiotics to their patients. There are a few steps you can take as well to protect yourself from exposure to these harmful bacteria. They’re essentially common sense, healthy habits, but they still deserve mentioning.

• Wash your hands and keep them clean.
• Stay up-to-date with vaccines.
• Prevent the spread of food-borne infections. Keep your kitchen clean.
• Wipe off household surfaces and playthings with an antibiotic cleanser.
• Avoid sexually transmitted infections. Practice safe sex.

Also, don’t be afraid to be your own advocate. If you get sick, there’s nothing wrong with asking your doctor if an antibiotic is the most appropriate treatment for you.. It may not be bacteria causing your illness, but rather a virus or fungus. In these cases, antibiotics wont help you. And antibiotics you really don’t need can hurt you later on.

by Patti DiPanfilo