Are we finally turning a corner in the fight against antibiotic resistance? Officials at the Centers for Disease Control and Prevention (CDC) seem to think so.
The CDC is touting the organization’s accomplishments throughout the United States in connection with their Antibiotic Resistance Solutions Initiative.
The initiative supports infrastructure to help detect and contain incidents of antibiotic resistance. These efforts include laboratory diagnostics, education, and helping local containment of outbreaks.
Some of the highlights released by the CDC include containment of a rare enzyme in Kentucky that can lead to antibiotic resistance.
The agency also noted the beginning of specialized testing on a deadly multi-drug resistance fungus called Candida auris.
It also noted improvement in local response and testing of resistant gonorrhea in California.
A nationwide map shows all the efforts made in individual states over the past year.
“We are positioned for a better and faster response to antibiotic resistance because of CDC’s investments in all 50 states of the nation,” Michael Craig, senior advisor for antibiotic resistance coordination and strategy at the CDC told Healthline. “We are starting to turn the corner, but we have to keep our momentum going. Robust action is still needed to truly turn the tide.”
The organization spent $163 million in 2017 on these initiatives.
Still an uphill fight
Antibiotic resistance is when germs and fungi stop responding to drugs designed to kill them.
It’s a major health concern because even small infections can become fatal.
While the CDC’s efforts are significant, there still remains an uphill battle for researchers against antibiotic resistance.
“These are all laudatory things that they are doing, but I don’t think that it is necessarily going to the heart of the problem,” Charles McKenna, PhD, a professor of chemistry and pharmaceutical sciences at the University of Southern California (USC), told Healthline. “The heart of the problem is that we are, for a number of pathogenic organisms, running out of effective drugs.”
McKenna says the response and diagnostic elements of the CDC are essential, but the fight against antibiotic resistance comes down to one thing: “better drugs.”
And there’s a race against time when it comes to beating antibiotic resistance.
“A microbe may have the ability to develop a resistant strain fairly rapidly. Our ability to come up with a brand-new drug, and get it identified and get it through the approval process after clinical trials, is many years,” said McKenna. “So, microbes have quite a big advantage over us, frankly.”
There is no one-size-fits-all solution either.
Different organisms respond to different drugs. Those organisms can also express differing levels of antibiotic resistance.
In some cases, pathogens have become resistant to all drugs except for a single type of treatment. If that drug stops working, “We would be back to square one,” said McKenna.
Taking on resistant fungi
McKenna is an expert on resistant fungi. He and a team of international researchers recently uncovered a new approach to deal with Candida albicans, a potentially deadly strain of antibiotic resistant fungus.
His work is particularly important, as resistant fungi such as Candida albicans and Candida auris have come under increasing scrutiny by the medical community.
Candida auris, first discovered in Japan in 2009, is considered an emerging threat because it has been documented as multi-drug resistant. In some cases, it has shown to be resistant to all three major classes of antifungal drugs — essentially rendering it untreatable.
Antibiotic resistant fungi are also associated with high mortality rates. Although information is still limited, estimates have been as high as 60 percent.
However, most of these infections and mortalities occur in hospital patients and those who are immunosuppressed. Pediatric patients and cancer patients on immunosuppressive drugs are at a particularly high risk.
Antibiotic resistant fungi and other microbes have the potential to linger in hospitals for weeks, if improperly sterilized. For hospital patients with compromised immune systems, the risk is out of their hands.
What you can do
From a public health perspective, there appears to be little that individuals can do to stop antibiotic resistance, except for using less antibiotics.
“Drug resistance is identified with promiscuous prescribing of drugs for minor conditions or even for conditions that are inappropriate,” said McKenna. “Sometimes the doctor will prescribe an antibiotic as a ‘just in case,’ but every time you do that you’re giving the microbe population a chance to figure out resistance.”
Many individuals are also familiar with the notion that when prescribed antibiotics, you need to take them all.
But, that may not be true. Last year, Healthline documented a changing attitude by some healthcare professionals on this issue with researchers saying that proliferating the “complete the course” message actually contributes to antibiotic resistance.
“Patients can ask questions and speak up when receiving medical care,” said Craig. “Patients are encouraged to ask about the risk of getting an infection; which vaccines are needed; and if antibiotics are the best course of treatment. Patients should never pressure a doctor to prescribe antibiotics.”