The Stealth Superbug Epidemic

162,000 Annual Deaths from Antibiotic Resistant Infections, Say New Estimates

My 95 year-old dad is on his life’s last leg. He lives in a memory unit, under hospice, with a terminal diagnosis of dementia. Something will kill him, eventually. In hospice programs and nursing homes, it’s often a superbug infection.  

Superbug is the colloquial term for a disease-causing bacteria that’s ‘resistant to’—i.e. immune to treatment with—multiple antibiotics. Technically, superbug infections are known as multi-drug resistant infections. One example are MRSA infections, which are caused by a super-resistant strain of staphylococcus bacteria.

The World Health Organization, the Centers for Disease Control and Prevention (CDC), and others consider the global epidemic of antibiotic resistance to be one of our biggest health threats. Superbugs sicken, disable and kill lots of Americans every year. Until recently, the most used figure was at least 23,000 annual deaths, along with 2 million infections. And yet those are considered “low-ball” numbers by just about everyone, including the CDC which derived them. The CDC figure only includes deaths in hospitals, ignoring deaths among folks like my dad who might die from MRSA or another superbug infection at their homes or in a senior facility. Counting the latter, Reuters reported in 2016 that there actually could be tens of thousands more superbug-related deaths each year, over and above the 23,000 or more deaths in hospitals.

In a bold move, the Infectious Diseases Society of America (IDSA), which represents physicians who specialize in infectious diseases, recently decided to move away from relying on CDC’s estimates, and instead uses a figure of  up to 162,044 deaths annually, or more than 7 times higher. The latter comes from an estimate of annual deaths published recently by a team from Washington University School of Medicine in the journal, Infection Control & Hospital Epidemiology.

Thinking big picture, the revised estimate makes multidrug-resistant infections the 3rd leading cause of deaths in the United States, after heart disease and cancer. The revised figure amounts to more deaths than are caused by all accidents, and more than double the number of opioid deaths.

Having good numbers can be important for setting national research or campaign priorities to combat antibiotic resistance. Regardless of whether the annual death toll is 23,000 or 160,000, however, we already know that cutting overall antibiotic use of antibiotics has to be a top priority if we’re going to maintain their effectiveness into the future. At the most basic level, use and overuse of these drugs drives bacteria to become resistant to them.

Pork and beef production remain two of the largest sources of unnecessary antibiotic use in the U.S.. In fact, more antibiotics are sold for use in raising pigs and cattle than are sold for treating sick people (nearly 50% more, actually). These medically important medicines are routinely and intensively fed to herds of pigs and cows that aren’t sick, ostensibly to ward off problems created by the crowded, often unsanitary, conditions under which those animals are being raised. Europe has legislated non-antibiotic approaches to these problems, such as cleaner farms, better nutrition, and less crowding. Until the situation changes in the U.S., we fear that other efforts to curb superbug infections and deaths will never be as successful as they could or should be.