Researcher Sketches Grim Outlook for Fight Against “Superbugs”

By Ed Rutkowski

Minneapolis Convention Center (May 22, 2019)—The already alarming number of deaths caused by organisms resistant to prescription drugs is likely to rise unless significant resources are directed to address the problem, according to Aurora Le, a researcher from the Indiana University School of Public Health-Bloomington who discussed the challenges of so-called “superbugs” yesterday at AIHce EXP 2019. Le, the coordinator of the Biosafety and Infectious Disease Training Initiative, a program directed by the National Institute of Environmental Health Sciences, discussed the challenges of antimicrobial resistance, or AMR, a term that describes the ability of microorganisms to stop antimicrobial medications from working properly.

One of the many challenges facing public health professionals is the public’s lack of awareness of AMR. Most people don’t think about the problem unless they personally know someone who has contracted a drug-resistant bacteria or virus. “AMR remains an increasing and ever-present issue in our society, but it’s happening a lot in silence,” Le said.

According to the Centers for Disease Control and Prevention, at least 2 million people in the United States acquire antibiotic-resistant infections each year, and at least 23,000 die annually from AMR. The direct costs of AMR to the U.S. total $20 billion each year, with an estimated $35 billion in indirect costs such as lost work, Le said. A 2014 publication of the U.K. government projected that antibiotic resistance will kill more people than cancer and diabetes combined by 2050.

Despite the enormous costs and the significance of the threat posed by AMR, few people are talking about it, Le said.

A number of causes have led to the rise of AMR. The over-prescription of antibiotics and the misuse of prescriptions—for example, by patients who stop taking medications once their symptoms disappear and by doctors who prescribe longer, more powerful courses of drugs than are necessary—have contributed to the proliferation of resistant microorganisms. Other causes include the overuse of antibiotics in fisheries and livestock, stalled production of new antibiotics, poor hygiene and sanitation, and poor infection control in healthcare facilities. Busy healthcare personnel who rely on hand sanitizers instead of taking the time to wash properly are unwittingly helping the superbugs; according to Le, alcohol-based sanitizers can actually cause the spores within the antimicrobial-resistant bacteria Clostridioides difficile to proliferate.

“Hand hygiene is very different than it used to be,” Le said. “We know that good old soap and water—you just can’t beat it.”

C. difficile, which causes life-threatening diarrhea and colitis, is one of the most significant of the AMR organisms. Each year, approximately 500,000 people are infected with C. difficile, and 15,000 die, according to CDC. Other AMR organisms that CDC identifies as serious threats are Methicillin-resistant Staphylococcus aureus, or MRSA, and Vancomycin-resistant Enterococcus, or VRE.

Le suggested that the problems hampering an effective response to AMR seem to be worsening. Public health resources tend to be shifted to address the crisis of the moment, Le said, and priorities requiring complex, years-long interventions such as AMR are neglected. Despite this grim outlook, Le believes that industrial hygienists can play an important role in halting and eventually reversing the tide of AMR. “Our capability of being there every day in the workplace, to start pushing for changes in safety culture” can “slowly move the needle in trying to address AMR.”

Ed Rutkowski is editor in chief of The Synergist.

View more Synergist coverage of the conference on the AIHce Daily page.