CDC demands $264.3 million or else thousands will die

cdcThe CDC (Centers for Disease Control and Prevention) is going Ed Harris-in-The Rock on Congress. But instead of unleashing V.X. gas on San Francisco, the health agency is warning that up to 37,000 Americans could die from antibiotic-resistant infections unless its budget is raised. Also, CDC director Tom Frieden is not holding a tourist group hostage in Alcatraz. In lieu of that, he opted for the much less extreme measure of releasing a new report in order to make his point. “We now clearly know not only how bad the problem is, but also what needs to be done and what the benefits will be if we do that,” Frieden said in a telebriefing. “If we take immediate national action with optimal infection control, stewardship efforts, we can prevent more than 600,000 antibiotic resistant and C. Diff infections, prevent 37,000 deaths over five years, and also avert 7.7 billion dollars of direct medical costs due to these infections.”

What needs to be done, according to Frieden, is to coordinate medical facilities so that they collaborate and let each other know about CRE (Carbapenem-Resistant Enterobacteriaceae) issues and other drug-resistant situations involving MRSA, C. Diff and others, in order to prevent hospital-acquired infections (HAIs). The agency’s report details computer models that delve deeper into how communication among hospitals, nursing homes and long-term care facilities could stop superbug infections from being passed on from one facility to another, and another, and another. In broad strokes, it’s a one-two punch; first, public health departments track and alert healthcare facilities to outbreaks in their area and the threat of drug resistant bacteria from nearby facilities. Second, healthcare facilities and others work together with public health authorities to have shared infection control measures to stop the spread of drug resistance and C. Diff. federal laws that protect patient privacy may have to be tweaked to accomplish all of that, though.

But most of all, money is of the essence when it comes to prepare health departments to assume this level of coordination – which includes hiring extra staff to perform infection-control and laboratory work in hospitals and long-term care facilities, and to collect, monitor and distribute data. “That's one reason why we've requested funds in the fiscal year 16 antibiotic solutions initiative to fund state protection programs in all 50 states and ten large cities to do this work,” Frieden explained. “These funds will also make it possible to find outbreaks sooner, improve laboratory testing, and track antibiotic resistance much better than we can today. But without those investments, we'll continue to struggle, and patients will continue to get infections that could have been prevented.” The $264.3 million budget request has the backing of last year’s National Strategy for Combating Antibiotic-Resistant Bacteria, but the House Appropriations Committee only approved $120 million, while the Senate approved a niggardly $30 million. “We need additional investment,” report author Dr. John Jernigan told Maryn McKenna of National “Not all health departments will be able to implement this without additional resources.”

On antibiotic-resistant bacteria

Bacteria develop antibiotic-resistance when the drugs developed to kill them have no effect on them. This resistance can be caused by several factors, including misprescription and overprescription of antibiotics. For example, as Frieden put it, “most C. Diff infections aren't resistant to antibiotics but when a person takes antibiotics, it destroys the body's defenses or the good bacteria and allows C. Diff to take over, putting patients at high risk for severe complications, including death.” The CDC director added that “antibiotic resistant germs cause more than two million illnesses and at least 23,000 deaths each year in the U.S.  C. Diff in addition to those caused about a half a million illnesses in 2011 and an estimated 15,000 deaths a year.” The agency’s report predicted that HAIs will increase by 10% from 310,000 to 340,000 in the next 5 years – which is itself only a part of the 2 million antibiotic-resistant infections estimated to occur every year in the U.S. overall.

Related Read:

- C'est difficile: Superbug kills 29,000 a year