Drug-resistant infections represent significant health issue, experts say

NEW YORK, Aug. 30 (UPI) -- Even as fall flu season approaches and COVID-19 cases rise nationally, the biggest contagion threat facing the United States may not be one disease but several that don't respond to existing medications, according to experts and recent data.

Collectively called antimicrobial-resistant infections, they sicken millions annually, and more than 35,000 people in the United States die from them every year, or about the same number reported in an above-average flu season, the Centers for Disease Control and Prevention estimates.

"During the COVID-19 pandemic and since, there has been a significant increase in hospital-onset infections related to multidrug-resistant organisms, despite a lot of efforts to curb these trends," Dr. Gabriela Andujar Vazquez, a specialist in geographic medicine and infectious diseases at Tufts Medical Center in Boston, told UPI in a phone interview.

"There is still a lack of understanding of something that is affecting all of us," Andujar Vazquez said.

Many of these infections occur in hospitals, while others cause those infected to be hospitalized due to serious illness, according to the CDC.

In many cases, multiple rounds of drug treatment are required to identify a medication that can snuff out the infection, Andujar Vazquez said.

All of which means it's important that people suffering from infections that don't seem to be resolving, despite drug treatment, work with their doctors to get the care they need, she said.

"There are ways to prevent these infections from happening," she added.

Infections in the millions

More than 2.8 million antimicrobial-resistant infections occur in the United States each year, according to the CDC.

In addition to the 35,000-plus who die from these diseases domestically, more than 1.27 million succumb to the infections globally, the agency estimates.

Several common infections, including staph, pneumonia, salmonella, sexually transmitted gonorrhea and C. diff can involve drug-resistant bacteria, the agency says.

Others that might be caused by drug-resistant bacteria are recurrent urinary tract infections, frequent skin infections or those acquired in a healthcare setting in which antibiotics are frequently used, according to Dr. Thomas Murray, a professor of pediatrics, infectious disease and global health at Yale School of Medicine.

"Antibiotic resistance is most often encountered when people receive multiple courses of antibiotics for infections," Murray, who is also the medical director for infection prevention at Yale New Haven Children's Hospital, told UPI in an email.

"Any infection can be caused by resistant bacteria," he said.

The biggest driver of drug-resistant infections is the overuse, or improper use, of the medications developed to treat them, Murray said.

This is not to say that antibiotics are bad -- in fact, they serve a vital purpose when used correctly to treat bacterial infections.

"There has been a renewed effort to improve antibiotic prescribing practices especially in clinics and outside hospitals," Murray said.

"The idea is to prescribe the right antibiotic to the right patient for the right reason for the right amount of time and guidelines exist to help providers decide when an antibiotic is necessary," he said.

"One thing that contributes to antibiotic resistance is the unnecessary prescribing of antibiotics for viral respiratory infections, as [these drugs] don't work against viruses."

However, there are other ways humans can be exposed to drug-resistant bacteria, including through animals, with even pet owners at risk for exposure when their companion animals are treated with antibiotics or antimicrobials.

In addition, workers at farms that breed animals for food production are at risk, particularly if these facilities regularly administer antibiotics to animals to control infections, and they can spread these infections to others.

The solutions

Over the past 20 years, healthcare facilities have implemented "antimicrobial stewardship programs" intended to ensure proper prescribing of these important drugs, but "prescribers still need reinforcement on when and how to diagnose an infection and when to prescribe antimicrobials," Andujar Vazquez said.

For example, many healthcare professionals continue to prescribe the drugs without a test-confirmed diagnosis, rather than waiting and potentially allowing patients to get sicker without treatment, she said.

"We doctors have to be more responsible -- doctors must know when and how to diagnose an infection and when to prescribe antimicrobials," she added.

Corrie Duffy, a food blogger based in Oregon, was diagnosed with an antibiotic-resistant staph infection, or MRSA, about three years ago after minor surgery.

"The infection started as a small, painful bump near the surgical site, but it quickly grew worse despite the antibiotics I was initially prescribed," Duffy told UPI in an email.

"After further testing, the doctors confirmed it was MRSA, which doesn't respond to common antibiotics," he said.

Duffy eventually recovered, following treatment with "a combination of stronger, targeted antibiotics" administered intravenously and several days in the hospital, he said.

"The recovery was slow, and ... it was a challenging experience that made me much more aware of the growing issue of antibiotic resistance," he said.

Although there's little many patients like Duffy can do to prevent drug-resistant infections, the public can take steps to limit their risk for exposure, according to Andujar Vazquez.

For example, she advises people prescribed antibiotics by their doctors to confirm that they need the drugs.

"Make sure you really have a bacterial infection, and not a virus," she urged.

"It is important to remember that many common infections like the cold will not get better faster with an antibiotic and that often a healthcare provider is doing the right thing by not prescribing an antibiotic," Yale's Murray added.

Also, do not take prescription medications offered by friends and family "just because you feel sick," Andujar Vazquez advised.

"Always go to the doctor and only take medications prescribed by your doctor," she said.

Routine vaccination -- including annual shots for the flu and COVID-19, as well inoculations against diseases such as measles and shingles -- can help prevent the spread of resistant bacteria by helping keep communities healthier and a person's overall immunity stronger, she said.

Preparing food properly can also help prevent transmission of drug-resistant bacteria, as many of these pathogens are spread through contaminated food. Practicing good hand hygiene, by washing hands regularly, and safe sex can also help, Andujar Vazquez said.

Drug-resistant bacteria are behind many sexually transmitted diseases, which are becoming increasingly prevalent, she added.

And, pet owners should talk with their veterinarian before putting their pets on antibiotics and confirm that the pet has a bacterial infection before starting the medications, according to Andujar Vazquez.

[Drug-resistant bacteria] is a complex problem, but the best solution is public awareness that it's a problem," she said. "That starts with education and asking the right questions."