Infection-Related Deaths Are Preventable

Health Care

Story at-a-glance -

  • The CDC found that a “coordinated approach” of health care facilities and health departments working together could significantly reduce the number of infection-related deaths
  • Up to 70 percent of carbapenem-resistant Enterobacteriaceae (CRE) infections could be prevented over five years by implementing these shared infection control strategies
  • Such strategies could also prevent 619,000 antibiotic-resistant and C. difficile infections, along with 37,000 deaths, over a five-year period

By Dr. Mercola

Each year, more than 2 million Americans are sickened, and at least 23,000 are killed, by antibiotic-resistant superbugs. Bacteria are, in essence, hard-wired to adapt to threats such as antibiotics and, at such point in time when they adapt to resist all of them, infections that were once easily treated will undoubtedly return with renewed force.

We’re seeing this increasingly in the US. Antibiotic overuse and inappropriate use bear a heavy responsibility for creating the superbug crisis we are facing today.

The pervasive misuse of antibiotics by the agriculture industry also plays a very significant role. Agriculture accounts for about 80 percent of all antibiotics used in the US.

Compare this to the 6 million pounds of antibiotics that are used for every man, woman, and child in the US combined. CAFOs (concentrated animal feeding operations), in particular, are hotbeds for breeding antibiotic-resistant bacteria because of the continuous feeding of low doses of antibiotics to the animals, which allows pathogens to survive, adapt, and eventually, thrive.

The European Centre for Disease Prevention and Control (ECDC) ruled that antibiotic resistance is a major threat to public health, worldwide, and the primary cause for this man-made epidemic is the widespread misuse of antibiotics.1

In the US, the Centers for Disease Control and Prevention (CDC) recently noted that without “immediate, nationwide improvements in infection control and antibiotic prescribing,” drug-resistant infections will only continue to increase…2 The one silver lining appears to be that such infections are preventable – if the right steps are taken to curb their spread.

Drug-Resistant ‘Nightmare Bacteria’ Infections Could Be Prevented with a ‘Coordinated Approach’

The CDC used mathematical modeling to show that a “coordinated approach” of health care facilities and health departments working together could significantly reduce the number of infection-related deaths.

For starters, they suggest that up to 70 percent of carbapenem-resistant Enterobacteriaceae (CRE) infections could be prevented over five years.

When bacteria such as Klebsiella produce the enzyme carbapenemase (referred to as KPC-producing organisms), the class of antibiotics called carbapenems will not kill them, giving rise to the name carbapenem-resistant Enterobacteriaceae, or CRE.3

CRE has been dubbed a “nightmare bacteria” by the CDC’s Director Tom Frieden because of their extreme resilience — it’s nearly impossible to kill them. These super germs pose a triple-threat that makes them nearly impossible to kill with conventional antibiotics:4

  • CRE are resistant to virtually all antibiotics, including the ones doctors use as a last-ditch effort to treat an infection
  • The organisms can transfer their virility to other bacteria, making containment much more of a challenge
  • CRE bacterial infections are quite deadly, with a fatality rate as high as 50 percent

The CDC recommends public health departments track and alert health care facilities to drug-resistant germ outbreaks in their area, and that health care facilities work together with public health authorities to implement shared infection control strategies.

When the current “status quo” approach is used (i.e. when patients are transferred between health care settings without shared information regarding drug-resistant infections), 2,000 patients get CRE, which impacts 12 percent of patients in the area.

The CDC noted that when a patient remains contained in once facility, the situation improves, but even then 1,500 patients get CRE, which impacts 8 percent of patients. With a coordinated approach, their model showed just 400 patients getting CRE, which impacts just 2 percent of patients.

These commonsense approaches – such as simply having a hospital notify another hospital or nursing home that an incoming patient is infected, then isolating the infected patient and adequately protecting staff to curb the infection’s spread – could prevent “tens of thousands” of deaths.5

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37,000 Lives Could Be Saved from Antibiotic-Resistant Infections

CRE was not the only superbug to be affected by the tighter infection control measures between hospitals and public health agencies. The CDC report noted that such strategies could also prevent 619,000 antibiotic-resistant and C. difficile infections, along with 37,000 deaths, over a five-year period. As CNN reported:6

“Currently, many hospitals work independently to control patient infections and don't report outbreaks to local or state health departments. The CDC report says this self-reliant approach isn't working, and patients are getting sick and dying as a result.

This is especially worrisome because patients can harbor drug-resistant bacteria on their skin or in their body without showing signs or symptoms.”

Proper “antimicrobial stewardship” was also recommended by the CDC, which refers to the responsible use of antibiotics. CNNcontinued:7

"‘Antibiotic stewardship comes down to using the right kind of antibiotics, at the right dose, for the right reason,’ Dr. Jesse T. Jacob, assistant professor at Emory University School of Medicine says, adding that doctors aim to ‘give antibiotics long enough to treat the infection, but not so long that side effects occur.’"

The White House has also called on the CDC to come up with a comprehensive plan to cut CRE infections by 60 percent by the end of this decade, and to slash C. difficile and methicillin-resistant Staphylococcus aureus (MRSA) infections in half.

To do that, the CDC intends to take a stronger stance against the practice of prescribing unnecessary antibiotics. Part of the CDC’s 2016 budget includes money to develop prescription surveillance programs in each state, as many states currently do not even collect data on antimicrobial resistance. As noted by Reuters:8

“More than half of all hospitalized patients will get an antibiotic at some point during their stay, but studies have shown that 30 to 50 percent of antibiotics prescribed in hospitals are unnecessary or incorrect, contributing to antibiotic resistance.

Recognizing that much of the misuse of antibiotics occurs outside of hospitals, the White House plan gives doctors who take part in Medicare or Medicaid three years to start reporting their antibiotics prescriptions, with financial incentives and penalties attached.”

Supercharged Tuberculosis Worsened by Doctors?

Antibiotic overuse is rampant all over the world, including in India where antibiotics are available for low cost and without a prescription. There it’s estimated that more than half of bacterial infections in Indian hospitals are resistant to commonly used antibiotics, and many are also resistant to the more powerful, broad-spectrum antibiotics.9

According to the World Health Organization (WHO), the first reports of extensively drug-resistant tuberculosis, or XDR TB, began surfacing in 2006.10 Since then, cases have been on the rise, including in India where 2 million people develop drug-resistant tuberculosis every year, and someone dies from it every two minutes.

Among them, about 62,000 harbor a variety that’s resistant to at least four types of drugs while 15,000 have “extensively drug-resistant” TB, which is resistant to virtually every available medication.11 As reported by Scientific American, inappropriate prescribing practices have worsened the disease in many cases rather than curing it:12

Too few diagnostic laboratories, too many poorly-trained health practitioners, and thousands of infected people living in crowded, unsanitary conditions has made India home to the world's largest epidemic of drug-resistant TB.”

What’s more, the disease is capable of easily becoming a worldwide epidemic. Scientific American continued:13

“… In June U.S. health authorities confirmed that an Indian patient carried this extreme form of the infection, called XDR-TB, across the ocean to Chicago. The patient drove from there to visit relatives as far away as Tennessee and Missouri. Health officials in several states are tracking down everyone with whom the patient — who is now quarantined and being treated at the National Institutes of Health in Maryland — had prolonged contact. 

The disease can be cured in only 30 percent of patients and sometimes requires surgery to remove infected parts of lungs.Although TB’s slow rate of infection makes explosive epidemics unlikely, the Chicago episode shows how easy it might be for the illness to become a worldwide export.”

Antibiotic-Resistant Bacteria May Be Deadlier

It’s commonly believed that antibiotic-resistant bacteria spread less easily than regular bacteria and become, in some ways, “less fit.” New research shows, however, that mice infected with antibiotic-resistant strains of Pseudomonas aeruginosa, bacteria that causes lung infections, were more likely to die than those infected with non-resistant strains.14 The resistant bacteria were also better at killing of certain immune cells, which suggests they may be more virulent and “fitter” than non-resistant varieties. Similar results were found with two other strains of bacteria, leading the researchers to suggest:15

“A potentially overlooked consequence of the acquisition of antimicrobial resistance could be enhanced fitness and virulence of pathogens… [this] raises a serious concern that drug-resistant strains might be better fit to cause serious, more difficult to treat infections, beyond just the issues raised by the complexity of antibiotic treatment.”

What Are the Risks of Long-Term and Early Use of Antibiotics?

Antibiotic overuse doesn't just make us vulnerable to minor infections that can become life threatening when the bacteria have developed resistance against one or more antibiotics, antibiotic use in childhood also appears to be linked to a host of lasting changes. In a study by researchers at the New York University School of Medicine, mice were given short, higher doses of two types of antibiotics, similar to what a child might be prescribed for an ear infection.

The mice that received either of the antibiotics (amoxicillin or tylosin, which is in the same class as the Z-Pak) weighed more, had larger bones, and experienced long-lasting changes in their gut microbiome.16 It’s unknown whether such changes occur in children, although it’s suspected they do – with unknown consequences. This is particularly concerning since the average US child receives three courses of antibiotics by the age of 2 and 10 courses by the age of 10.17

Recent research also suggests children treated with antibiotics raise their risk of developing health problems in adulthood, including making them more susceptible to infectious diseases, allergies, obesity, and autoimmune disorders as they grow older.18

Another type of antibiotics, aminoglycosides, have been linked to an increased risk of hearing loss, particularly in those with inflammation from bacterial infections (which is typically of the infections treated with these drugs). Aminoglycosides are often used to treat meningitis, bacteremia, and respiratory infections in people with cystic fibrosis, as well as in newborn infants.

An estimated 80 percent of infants admitted to US neonatal intensive care units (NICUs) also receive the drugs, and their rate of hearing loss is 2 to 4 percent, compared to 0.1 to 0.3 among full-term infants.19 The authors noted that inflammation caused by bacterial infections significantly boosts the uptake of the antibiotics into the inner ear, creating the increased hearing-loss risk.

Author Peter Steyger, professor of Otolaryngology- Head and Neck Surgery at Oregon Health & Science University in Portland, said:20

“Currently, it's accepted that the price that some patients have to pay for surviving a life-threatening bacterial infection is the loss of their ability to hear… We must swiftly bring to clinics everywhere effective alternatives for treating life-threatening infections that do not sacrifice patients' ability to hear… When infants lose their hearing, they begin a long and arduous process to learn to listen and speak. This can interfere with their educational trajectory and psychosocial development, all of which can have a dramatic impact on their future employability, income, and quality of life.”

CAFOs May Be Transferring Antibiotic-Resistant Disease to Humans

There’s no question that antibiotics must be used judiciously – and hospitals and other health care settings must use careful communication and other protections to prevent the spread of antibiotic-resistant disease. However, antibiotic-resistant disease being spread by CAFOs and through the US food supply must also be addressed. According to the CDC, 22 percent of antibiotic-resistant illness in humans is in fact linked to food,21 but a more accurate statement might be linked to food from CAFOs.

Take Klebsiella pneumonia, a bacteria that can lead to pneumonia, bloodstream infections, wound and surgical site infections, and meningitis. Klebsiella are often found in the human intestinal tract, where they are normally harmless.

But if your immune system is compromised and you get exposed to an especially virulent drug-resistant form of Klebsiella, the consequences to you can be deadly. It wasn’t thought to be transmitted via food… until now. New research published in the journal Clinical Infectious Diseases showed that turkey, chicken, and pork sold in US grocery stores may contain klebsiella pneumonia.22

In fact, 47 percent of samples tested contained the bacteria, which was, in some cases, nearly identical to strains found in people with klebsiella pneumonia infections during the same time period. US chicken is not currently tested for klebsiella pneumonia bacteria. In the case of CAFO chicken, you’ve probably heard about the risks of salmonella, but in addition to that and klebsiella pneumonia, campylobacter is particularly problematic. Chickens and turkeys normally harbor campylobacter in their digestive tracts without becoming ill.

Antibiotics routinely given to the birds in CAFOs don't completely eliminate campylobacter from the birds' intestinal tracts, so the surviving bacteria are the tougher ones that have resisted being killed off by the antibiotics. Those bacteria proliferate in the birds and end up being passed on to you — along with their antibiotic-resistance. Campylobacter bacteria are found on chicken carcasses in slaughterhouses and in commercial poultry products — including on the outside of poultry packaging — where they can easily infect you, your children, or even your pets.

Companies Responding to Consumer Demand for Antibiotic-Free Chicken

In March, McDonald’s announced they will only buy chicken raised without antibiotics important to human medicine, a change they also plan to phase in over the next two years. Other companies jumping on the anti-antibiotics bandwagon include Pilgrim’s Pride Corporation, the second-largest US poultry processor, which recently announced plant to remove antibiotics from a quarter of its chickens by 2019.

Perdue Farms also noted that more than 95 percent of the chickens it produces are raised without human antibiotics while more than half are raised with no antibiotics at all.23 In a first for a major poultry company, more than half of its chickens will be allowed to be labeled “no antibiotics ever.”24
Chipotle, Panera Bread, and Shake Shack also offer antibiotic-free meat and poultry, while Chik-fil-A, which is actually the largest chicken buyer in the US, announced last year that they would stop buying chicken raised with any antibiotics. This is an important distinction, because while many companies are pledging to stop the use of human antibiotics, the meat may still contain veterinary antibiotics. 

McDonald’s, for instance, said the farmers who supply chicken for its menu will continue to responsibly use ionophores, a type of antibiotic not used for humans that helps keep chickens healthy.”25 Perdue also plans to continue to use ionophores, although said it may continue to reduce them “depending on consumer response.”26 Fortunately, demand is growing, with sales of antibiotic-free and “natural” chicken rising about 20 percent (in pounds of meat sold) in the last year.27

And it’s not only chicken that’s demanding less use of antibiotics. Jeff Lyons, who oversees fresh foods at Costco, noted “The whole industry is starting to shift.” The company recently cut down on its purchases of Chilean salmon significantly after the country began using “record levels” of antibiotics to treat a prevalent bacterial infection. Although the drugs are approved by the US government, Costco opted to reduce imports of Chilean salmon amidst concerns of drug resistance and dangers to human health.28

Tips for Fighting Back Against Antibiotic-Resistant Disease

You can help yourself and your community by only purchasing antibiotic-free meats and other foods, and using antibiotics only when absolutely necessary. This is an important step that I urge everyone to take, even though ultimately the problem of antibiotic-resistance needs to be stemmed on a global level.

That said, your lifestyle choices are the most critical factors in determining the health of your immune system, which determines your ability to resist infections. The stronger your immune defenses, the less chance a microbe – antibiotic-resistant or otherwise – will have of gaining a foothold in some part of your body. Below are some basic strategies for supercharging your immune system. You may also want to download my free special report about how to protect yourself from super germs.

  • Optimize your diet. Avoid foods that tax your immune system such as synthetic trans fats, fried foods, processed foods, sugar and grains; reduce carbohydrates (sugar, grains, and fructose) and protein, replacing them with high-quality fats. Fifty to 70 percent of your total intake should be fat. Most of your diet should be fresh, whole foods, like organic vegetables and grass-pastured meats and dairy, and beneficial fats, such as butter and fermented dairy from grass-pastured animals, cheese, egg yolks, and avocados.
  • A great portion of your immune system resides in your GI tract, which depends on a healthy, balanced gut flora. One of the best ways to support this is by incorporating naturally fermented foods into your diet, working up to 4 to 6 ounces per day. One large serving of several ounces of fermented foods can supply you with around 10 trillion beneficial bacteria, which is about 10 percent of the population of your gut. You can take a high-quality probiotic supplement, but the actual fermented foods offer the greatest benefit.

  • Exercise regularly. Exercise improves the circulation of immune cells in your blood. The better these cells circulate, the more efficient your immune system is at locating and eliminating pathogens in your body. Make sure your fitness plan incorporates weight training, high-intensity exercises, stretching, and core work.
  • Get plenty of restorative sleep. Recent research shows sleep deprivation has the same effect on your immune system as physical stress or disease, which is why you may feel ill after a sleepless night.
  • Have good stress-busting outlets. High levels of stress hormones can diminish your immunity, so be sure you’re implementing some sort of stress management. Meditation, prayer, yoga, and Emotional Freedom Technique (EFT) are all excellent strategies for managing stress, but you’ll have to find what works best for you.
  • Optimize your vitamin D levels. Studies have shown that inadequate vitamin D can increase your risk for MRSA and other infections, which can likely be extended to other superbugs. Your best source of vitamin D is through exposing your skin to the sun or using a safe tanning bed. Monitor your vitamin D levels to confirm they’re in the therapeutic range, 50 to 70 ng/ml. If you can’t get UV exposure, consider taking an oral vitamin D supplement.

In addition to the basic lifestyle measures listed above, there are natural agents that science has shown to be naturally antibacterial. The following deserve special mention.

  • Vitamin C. Vitamin C’s role in preventing and treating infectious disease is well established. Intravenous vitamin C is an option, but if you don’t have access to a practitioner who can administer it, liposomal vitamin C is the most potent oral form. For more information on vitamin C, listen to my interview with Dr. Ronald Hunninghake, an internationally recognized vitamin C expert. If you choose to use supplement vitamin C, liposomal C seems to be the best form to use.
  • Garlic. Garlic is a powerful antibacterial, antiviral, and antifungal. It can stimulate your immune system, help wounds heal, and kill antibiotic-resistant bacteria (including MRSA and multi-drug resistant tuberculosis), plus has shown more than 100 other health promoting properties.29 For highest potency, the garlic should be eaten fresh and raw (chopped or smashed.)
  • Olive leaf extract. In vitro studies show olive leaf extract is effective against Klebsiella, a gram-negative bacteria, inhibiting its replication, in addition to being toxic to other pathogenic microbes.
  • Manuka honey. Manuka honey, made from the flowers and pollen of the Manuka bush, has been shown to be more effective than antibiotics in the treatment of serious, hard-to-heal skin infections. Clinical trials have found Manuka honey can effectively eradicate more than 250 clinical strains of bacteria, including resistant varieties such as MRSA.
  • Tea tree oil. Tea tree oil is a natural antiseptic proven to kill many bacterial strains (including MRSA).30
  • Colloidal silver. Colloidal silver has been regarded as an effective natural antibiotic for centuries, and recent research shows it can even help eradicate antibiotic-resistant pathogens. If you are interested in this treatment, make sure you read the latest guidelines for safe usage of colloidal silver as there are risks with using it improperly.
  • Copper. Replacing fixtures with certain copper alloys can help kill bacteria, even superbugs. Installing copper faucets, light switches, toilet seats, and push plates in germ-infested areas such as hospitals and nursing homes could potentially save thousands of lives each year.