In my last post I talked about the under-appreciated emergence of “nightmare bacteria” (those are the Centers for Disease Control and Prevention’s words, not mine) that are widely distributed in hospitals and nursing homes around the world and do not respond to a last-ditch small family of antibiotics called carbapenems. That seemed dire enough, but new research suggests the problem, bad as it looks, has been understated.
There’s an ahead-of-print article in Antimicrobial Agents and Chemotherapy whose authors include David Shlaes, a physician-researcher and former pharmaceutical executive, now consultant, and Brad Spellberg, an infectious disease physician on the UCLA medical faculty and author among other books of Rising Plague, about antibiotic resistance. In a commentary examining the Food and Drug Administration’s promised “reboot” of antibiotic development rules, they analyze privately gathered data on resistance in the United States and conclude the incidence of highly resistant bacteria is greater than the CDC has estimated.
I’ll let them tell it (I’ve reparagraphed for clarity). For non-medical readers, the organisms being discussed here are Klebsiella and Acinetobacter, common causes of ICU infections that have become resistant first to a class of drugs called the third-generation cephalosporins, and after that, to the carbapenems. After the carbapenems, there are literally one to two drugs left, neither of them very effective (and one of them quite toxic).
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