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Tackling superbugs, 'crisis of this generation,' report says

Too many antibiotic prescriptions and deadly infections must be countered by health systems, group suggests.

UCLA Ronald Reagan Medical Center, where two patients died and 179 were exposed to CRE.UCLA Ronald Reagan Medical Center, where two patients died and 179 were exposed to CRE.

Many Americans are unaware of antibiotic-resistant infections, yet the risk they pose to an aging society shows no signs of abating unless major changes are adopted by providers and the agriculture industry, according to Consumer Reports.

In a new national survey by Consumer Reports, more than 40 percent of adults said they are not familiar with the problems of antibiotic resistant bacteria and their link to hospital infections—including the deaths of some 37,000 Americans annually from so-called “superbugs.” The Centers for Disease Control and Prevention estimates that inappropriate antibiotic use in human healthcare as well agriculture account for 2.25 million infections and 37,000 deaths in the U.S. annually.

Consumer Reports is probing the issue of superbugs as part of public campaign with seven other organizations. The message is targeted at key healthcare customer segments: the Baby Boomer generation aging into Medicare and senior citizens, both of them among the most likely to be hospitalized.

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[Also: 'Superbug' infections sicken four patients at Cedars-Sinai]

"Antibiotic-resistant infection is the health crisis of our generation,” said Consumer Reports President and CEO Marta Tellado. “The emergence of antibiotic-resistant superbugs is a major threat to the health and well-being of millions of Americans,” said Lisa Gill, prescription drugs editor, Consumer Reports. “The problem is fixable, but we must act quickly and work together to change our behaviors to preserve the effectiveness of these life-saving drugs.”

The Consumer Reports campaign is calling for hospitals and providers to disclose more information about antibiotic use and antibiotic-resistant infections and to have mandated real-time reporting of outbreaks. The group is also urging healthcare organizations to focus on more accurate testing to determine which infections can actually be cured with an antibiotic. The group argued that this should emphasize accurate diagnosis of viral infections, which can’t be cured with antibiotics but are sometimes prescribed anyway. And, pointing to a big contributor beyond physicians, Consumer Reports is calling for a ban on “growth promotion” antibiotic use in healthy livestock.

Antibiotic resistance and its dangers have been decades in the making as infectious “gram-negative” and “gram-positive” bacterial strains have evolved. Gram-negative bacteria have been problems as hospital-acquired infections that can cause secondary meningitis and ventilator-associated pneumonia, along with the more recent emergence of carbapenem-resistant Enterobacteriaceae implicated in endoscopy-related infections at Cedars Sinai and UCLA Health in Los Angeles.

Perhaps most notorious is the gram-positive Clostridium difficile infection, which shows up about 25 percent of the time in hospital patients, the rest of the time in other healthcare settings, and is linked to about 14,000 U.S. deaths annually.

While many healthcare-associated infections have declined in the past decade, C. difficile infection rates and deaths have “climbed to historic highs,” as CDC Director Thomas Frieden, MD, put it. In 2011, according to the CDC’s most recent data, C. difficile caused some 453,000 infections in 2011 and contributed to 29,000 deaths.

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“C. difficile harms patients just about everywhere medical care is given,” said Frieden said. “Illness and death linked to this deadly disease do not have to happen.”

Other infections are actually starting to pose risks for people who never set foot in a hospital or medical setting, such as methicillin-resistant Staphylococcus, or MRSA, which claims victims like Tucson teenager Addie Rerecich. She spent five months hospitalized fighting a community-acquired MRSA infection and needed a lung transplant to survive.

In its public information campaign, Consumer Reports is urging patients to “think twice about the need for antibiotics” and not not ask doctors to prescribe them. The group’s survey found that about 20 percent of people who received an antibiotic prescription in the last year had asked a health practitioner to write it. The group is also advising patients to request targeted drugs geared towards the individual infection’s bacterial cultures.

For hospitals, the push for increased public awareness of antibiotic-resistant infections may help them adapt to the national effort for a baseline of quality that minimizes preventable harm, as Medicare increases its penalties on facilities with high infection and complication rates. The increased awareness is also another reason to expand non-hospital services, because one of the best ways to prevent a hospital-acquired infection is to avoid hospital admission unless acutely necessary in the first place.

The Obama Administration has vowed $1.2 billion to fight superbugs with the federal government’s first National Action Plan for Combating Antibiotic Resistant Bacteria, outlining five goals: slow the emergence of resistant bacteria and prevent infections; strengthen national surveillance; advance development and use of rapid diagnostic tests; accelerate basic and applied research and development; and improve international collaboration and capacities.

Twitter: @AnthonyBrino