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Protecting Americans from Preventable Infections: Working Together Will Save Lives

Tom Frieden CDC“Alone we can do so little; together we can do so much.” Those words spoken by Helen Keller nearly a century ago remain powerful and relevant today.

A new report from the Centers for Disease Control and Prevention (CDC) projects that thousands of lives could be saved every year if health care facilities and public health departments work together to track and stop antibiotic resistance – and if they communicate with each other about these infections to prevent spread from one facility to another.

Even if one health care facility follows all recommended infection control practices, antibiotic-resistant organisms can spread when patients are transferred among facilities. Even the best health care facilities can’t go it alone when it comes to antibiotic-resistant infections and C. difficile.

We need to protect our whole community; advance warning of possible antibiotic-resistant infections at one facility allows actions to be taken to prevent spread at the receiving facility.

New modeling data from CDC project that a community-wide approach – in which hospitals, long-term acute care facilities, nursing homes and health departments across an area work together – could reduce the number of patients infected with carbapenem-resistant Enterobacteriaceae (better known as CRE) by up to 70% over five years. CRE is a nightmare bacteria because it does not respond to most antibiotics and is extremely deadly should it enter the bloodstream – especially if a patient is already sick. A significant drop in these infections would be a life-saving scenario for patients.

Health care facility administrators are key to making this coordinated approach a success. Hospitals, long-term acute care facilities and nursing homes all need better systems to alert one another when transferring patients carrying drug-resistant bacteria and C. difficile. Strict infection control practices must be implemented in every health care setting, and clinical staff need access to prompt and accurate laboratory testing to identify antibiotic-resistant bacteria.

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The End of Antibiotics. Can We Come Back from the Brink?

Tom Frieden CDCAntibiotic resistance — bacteria outsmarting the drugs designed to kill them — is already here, threatening to return us to the time when simple infections were often fatal. How long before we have no effective antibiotics left?

It’s painfully easy for me to imagine life in a post-antibiotic era. I trained as an internist and infectious disease physician before there was effective treatment for HIV, and I later cared for patients with tuberculosis resistant to virtually all antibiotics.

We improvised, hoped, and, all too often, were only able to help patients die more comfortably.

To quote Dr. Margaret Chan, Director General of the World Health Organization: “A post-antibiotic era means, in effect, an end to modern medicine as we know it.”

We’d have to rethink our approach to many advances in medical treatment such as joint replacements, organ transplants and cancer therapy, as well as improvements in treating chronic diseases such as diabetes, asthma, rheumatoid arthritis and other immunological disorders.

Treatments for these can increase the risk of infections, and we may no longer be able to assume that we will have effective antibiotics for these infections.

Last September, CDC published our first report on the current antibiotic resistance threat to the United States.

The report conservatively estimates that each year, at least 2 million Americans become infected with bacteria resistant to antibiotics, and at least 23,000 die.  Another 14,000 Americans die each year with the complications of C. difficile, a bacterial infection most often made possible by use of antibiotics. WHO has just issued their report  on the global impact of this health threat.

It’s a big problem, and one that’s getting worse. But it’s not too late. We can delay, and even in some cases reverse the spread of antibiotic resistance.

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