What is Most Threatening About Antibiotic-resistant Pathogens?

Lauri A. Hicks, DO, captain, US Public Health Service, director, Office of Antibiotic Stewardship, medical director, Get Smart: Know When Antibiotics Work, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, examines the threat that antibiotic resistance poses to modern medicine.

Interview Transcript (slightly modified for readability)

“[What’s particularly worrisome is] the potential for infections, particularly gram-negative infections, to spread in a way that [would leave us with no] opportunities or any antibiotics that are effective for those types of infections. We have some good treatment options for [Staphylococcus] aureus infections that are resistant, MRSA, which is the most common gram-positive resistant organism that we talk about frequently. The other types of infections that I’m really worried about are the infections that are caused by the bacteria that tend to live in our gut but can enter into, say, our urinary tract systems, or can potentially cause a bloodstream infection or an intra-abdominal infection. We’re seeing more and more of these types of gram-negative bacteria, and an example is [Escherichia] coli, that are highly resistant to multiple types of [antibiotics].

We’re already in a situation where we have very few or sometimes no options for treatment. If we continue on this path we really may be in a situation where common infections, [like] a urinary tract infection, [or] a case of a patient who has an outpatient pneumonia, someone who injures their leg and gets an infection in their leg, that these infections that we once thought we could treat with an oral antibiotic, will now either require a hospitalization or we’d be in a situation where we couldn’t treat it at all.

That’s what really keeps me up at night, that we need to be thinking “okay, well what do we do in this scenario?” I think what we talked about earlier is really how we have to tackle this. This is not any individual’s fault. We need to think about this as a collective problem that we can all come together to fight. We also have to make sure that we engage all the different stakeholders that can play a role in addressing this problem.”