#41: Antibiotic Innovators vs Superbug Resistance

 We hear about it every day in the news to the point we start to ignore the talking heads.  We know it affects someone in the US every 11 seconds and leads to one death every 15 minutes.  Yes, I am talking about antibiotic resistant infections.  Huh?  You’re telling me you don’t hear about this every minute of every day?  Since the United Nations issued a report in April of 2019 titled, No Time To Wait: Securing The Future From Drug-Resistant Infections, claiming superbugs could kill 10 million people annually by 2050, maybe we should be hearing about this daily.  Depending upon which source you read, this is 3.5 to 10 times the number of people estimated to die world-wide from COVID by the end of 2021.  Speaking of that wonderful C bug with the S on it’s chest,  COVID has actually been a contributor to overuse of antibiotics.  In New York City last year during March and April, approximately 1700 people a day were hospitalized with COVID and 70 percent of these received an antibiotic.  According to the American Journal of Health-System Pharmacy, only about 3% to 8% had bacterial co-infections at the time of admission.   This is by no means a condemnation of those front-line providers as the hyper-inflammatory syndrome caused by COVID made it difficult to differentiate between bacterial and viral infections, however, it does bring to light how easy it is to overprescribe.

 Ironically the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR Act) is awaiting reintroduction to Congress this year.  This legislation would introduce a subscription type model for antibiotic innovators, to financially incentivize them into developing more superbug appropriate antibiotics, more quickly.  In 2019 $9.7 billion in private investment went into oncology research, compared to $132 million for antibiotic research.  This highlights where the profitability is, however severe infection and sepsis are among the most common reasons that cancer patients are admitted to intensive care units.  The CDC says 2.8 million Americans acquire serious infections caused by antibiotic-resistant bacteria each year, with 35,000 of them dying.  Without the knowledge of what specific pathogen is causing an infection many times non-specific systemic antibiotic use is or was the norm.  (None of our referring providers do that)  As a result, C. difficile has proliferated among the elderly.  CDC considers this an urgent threat as up to 15,000 people in America die from C. difficile every year.   

This antibiotic over-usage is a big problem that does not have a simple fix.  Testing for specific pathogens as well as using antibiotic resistant marker testing is one way to combat this pervasive problem.  As a molecular PCR lab, our goal is to be part of your team to help you make the best and most appropriate decisions you can in treating your patients.  This type of testing may be a paradigm shift for some of you, but we are here to make that easier.  Let us know what we can do to help you better serve your patients.  As always , we thank you for your business.  It is always appreciated.  

 

Lance Benedict

President/CEO Industry Lab Diagnostic Partners 

#40: Sars-Cov-2 Variants of Concern

On Wed March 17^th The Lancet revealed a large-scale study looking at the testing data of four million people in Denmark, which revealed that Sars-CoV-2 virus reinfection is rare.  It did, however, go on to say that adults 65 and older who tested positive for Sars-Cov-2 are more likely to be reinfected than younger people.  Those 65 and older had about 47.1 percent protection against reinfection vs. an 80 percent protection for those younger than 65. 

As of March 18^th, the more contagious B.1.1.7 UK virus has now been found in every state according to the CDC.  One peer-reviewed study published on March 10^th found that people infected with this UK variant are 32 to 104 percent more likely to die than those infected with the original strain.  The UK variant is now circulating in more than 45 countries.  The CDC projected this would be the dominant strain in the U.S. by April and it appears it is.  The South African variant (B.1.351) is now in at least 24 states and the first Brazilian variant (P.1.) is in nine states.  These are all variants of concern.  Currently, the CDC is tracking two other “variants of concern” that are in California and New York City.   Aren’t those foreign countries?  Only kidding. 

Did you know that we now have a term for people who develop long-lasting symptoms from having COVID?  They are called “long haulers”.  Don’t ask me.  According to a March 9^th study in the journal Nature Medicine these individuals are more likely to experience five or more symptoms in their first week of illness.  Early symptoms most predictive of someone being a long-hauler were fatigue, headache, breathing difficulty, a hoarse voice, and muscle pain.  Additionally, those with a higher body mass index and women were found more likely to be long-haulers.  You won’t catch me calling any woman a “long hauler”.  Symptoms long-haulers may suffer from include dizziness, insomnia, confusion, and a racing heart among others.  In another study of 1,733 hospitalized coronavirus patients, published in The Lancet, 3 out of 4 patients still suffered from at least one symptom 6 months after being released from the hospital.

According to the CDC, 95 percent of those who have died from COVID in the U.S. were over 50 years of age and eight out of ten who have died were over 65.  I am not sure these stats are 100 percent accurate as there have been many reports of the cause of death listed as COVID if the person had the virus regardless of any other disease they may have previously had.  Just saying!

More challenges await all of us as we enter the spring and summer.  Vaccines, Variants, re-opening, as well as new rules to live by.  Take one day at a time and stay the course.  We are a resilient country and we will get through this.  Thank you for trusting ILDP to perform your testing.  We appreciate it.

 

Lance Benedict

President/CEO Industry Lab Diagnostic Partners