Infectious diseases experts address growing "superbug problem"

A new report from the Infectious Diseases Society of America outlines a three-pronged strategy to address the growing public health and patient safety crisis of antibiotic-resistant "superbugs" and other antimicrobial-resistant infections.

Research shows the "bad bug" methicillin-resistant Staphylococcus aureus (MRSA) alone infects more than 94,000 people nationally, killing an estimated 19,000 people.  Concerns have also arisen about whether MRSA can be transmitted to humans through farm animals, such as pigs. 

A recent report in the Journal of the American Medical Association noted that more than half the cases were in the health care system. The most common ways the bug spreads are through open wounds and exposure to medical equipment. But the drug-resistant germ has also been spreading through schools, daycare facilities and locker rooms.

According to the authors of the study, prevention is key, which means stopping the overuse of antibiotics and improving hygiene procedures, such as hand-washing.

But the problem goes well beyond MRSA. IDSA is concerned about other drug-resistant superbugs looming on the horizon, including E. coli and tuberculosis, as well as less-familiar names such as Clostridium difficile, Klebsiella, Pseudomonas aeruginosa, and Acinetobacter. 

With the number of "superbug" infections rising and the number of effective drugs available to fight them shrinking, the new report outlines the Societys "Wish List" of strategies and specifically calls for:

  1. Better federal coordination and leadership, greater attention and education, and significant new funding for U.S. and global antimicrobial resistance activities.  Prevention, control, monitoring, and research all must be firmly strengthened to tackle drug-resistant "bad bugs" in the U.S. and those that threaten us from other countries.
  2. New incentives to increase research and development (R&D) of antibiotics, diagnostic tests, and other high-priority infectious diseases products. These products are vital to public health and patient care. Yet they are rarely developed because of technical difficulties, and because they do not generate the return on investment offered by drugs for chronic conditions such as heart disease.  
  3. An end to the non-therapeutic use of antimicrobials in agriculture. The practice of feeding food animals antibiotics to slightly increase their growth rate is undermining the therapeutic value of these critical medications for people. The United States is far behind many other developed nations in this regard. Other countries already have successfully taken on agricultural special-interest lobbyists who support this risky practice that provides no public health benefit.

Three IDSA-backed pieces of legislation now before Congress will begin to implement these key strategies:

  • S. 2313/H.R. 3697, the comprehensive "Strategies To Address Antimicrobial Resistance (STAAR) Act."  (For more information, see www.idsociety.org/STAARAct).

  • S. 2351/H.R. 4200, a bill to grant R&D tax credits to manufacturers of critical infectious diseases products.

  • S. 549/H.R 962, the "Preservation of Antibiotics for Medical Treatment Act," will phase out the use of antibiotics for growth promotion in food animals.

IDSAs report was issued during a major federal meeting called by the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Food and Drug Administration (FDA) to update the federal Action Plan to Combat Antimicrobial Resistance, first issued in 2001. For the meeting, the federal government brought together a panel of more than 60 medical, veterinary, and infectious diseases consultants, including IDSA physician leaders, to reshape and strengthen existing action items relating to antimicrobial resistance surveillance, prevention and control, research, and product development. 

The Societys report is intended to help guide the revision of the federal Action Plan, influence congressional action on the three IDSA-endorsed bills and, finally, to press for a significant increase in appropriations to support federal efforts. 

"A major flaw with the Administrations approach, beginning as far back as 2001, has been the lack of sufficient resources to implement the federal Action Plan," said Robert J. Guidos, JD, IDSAs director of public policy and government relations who announced the new report during the Atlanta meeting.  The IDSA wrote President Bush calling for strengthened funding for CDC, NIH, FDA, and the other agencies responsible for implementing the Action Plan, a revised version of which is expected to be released in 2008.

"Resistance to antibiotics is inevitable," said Brad Spellberg, MD, lead author of IDSAs report.  "For us to have any chance to keep up with the epidemic of antibiotic resistant infections will require a significant investment of new resources, and a comprehensive and cooperative effort of federal officials, physicians, patients, health care facilities, and drug and diagnostics manufacturers. Our success will depend on the partnerships we create, the resources brought to bear, and the support we lend one another."