Nosocomial Antibiotic Resistance Higher Than Previous Estimates

Antibiotic resistance among hospital-acquired infections (HAIs) has reached crisis levels, while drug developments to combat the rise have fallen short, claims a new commentary.

Researchers at the Los Angeles Biomedical Research Institute (LA BioMed; CA, USA), Eurofins Global Central Laboratory (Chantilly, VA, USA), and other institutions conducted an analysis of antibiotic resistance in the United States, examining key bacterial pathogens in a representative sample of US hospitals both within and outside of the intensive care unit (ICU) for the years 2009-2012. The researchers focused on resistance to third generation cephalosporins (exemplified by ceftazidime-resistance) and resistance to carbapenems (exemplified by imipenem).

The researchers found that the rise in antibiotic resistance among three common forms of HAIs is much greater than reported by the US Centers for Disease and Protection (CDC; Atlanta, GA, USA) in 2008. Among the findings is that the resistance of Acinetobacter baumannii to carbapenems is more than 50%, while the CDC placed it at 11%; the resistance among E. coli to third generation cephalosporins was 8%–11%, while the CDC found it to be 5%; and the resistance to klebsiella to third generation cephalosporins was 20%–27%, while the CDC found it to be 15%.

The results demonstrate that carbapenems are already obsolete for common A. baumannii, in both ICU and non-ICU patients, and for urinary and non-urinary infections. The resistance to carbapenems among these isolates is now between 7%–11%. The researchers warn that we will continue to face more and more infections for which treatment options are worse and worse, even with the late stage pipeline of new antibiotics now in place, and blame the disaster on the failure of US Food and Drug Administration (FDA) to implement the 2012 program to “reboot” antibiotic development. The commentary was published on July 29, 2013, in Antimicrobial Agents and Chemotherapy.

“None of the antibiotics under development today can address all of these antibiotic-resistant infections. To encourage antibiotic development, the pharmaceutical industry must see that there is a path for a return on its investment,” said commentary coauthor Brad Spellberg, MD, of LaBioMed. “A complete overhaul of the approaches to resistance, disease, and prevention could change the continuing upward trajectory of antibiotic resistant infections. To do anything less invites a bleak postantibiotic future, in which infectious diseases once again reign supreme.”

Related Links:
Los Angeles Biomedical Research Institute
Eurofins Global Central Laboratory
US Centers for Disease and Protection