Antibiotic Resistance

Antibiotic resistance is a worlwide problem.  New forms of antibiotic resistance can cross international boundaries and spread between continents with ease.  World health leaders have described antibiotic-resistant microorganisms as “nightmare bacteria” that “pose a catastrophic threat” to people worldwide.

The CDC estimates that each year, at least, 2 million people in the US alone are infected with drug-resistant bacteria and at least 23,000 people as a direct result.  The CDC has awarded more than $200 million through the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperatrive agreement to help states, cities, counties and territoriest prevent, detect, respond to, and control the growing threats posed by emerging and re-emerging infectious diseases.

The FDA responded with updated guidance, highlighting the use of adaptive clinical trials in development of new antibiotics.  The GAIN Act further incentivizes antibacterial drug development by prioritizing review and enabling fast-track approval by the FDA.

CRE

Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities.  CRE have become resistant to nearly all existing antibiotics.  Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.

C. Difficile

Clostridium difficile (C. difficile) causes life-threatening diarrhea.  These infectios mostly occur in people who have had both recent medical care and antibiotics.  Often, C. difficile infetions occur in hospitalized or recently hospitalized patients.

MRSA

Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities.  CRE have become resistant to nearly all existing antibiotics.  Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.

Pseudomonas aeruginosa

Pseudomonas aeruginosa is a common cause of healthcare-associated infections including penumonia, bloodstream infections, urinary tract infections and surgical site infections.

Pneumococcus

Streptococcus pneumoniae (or penumococcus) is the leading cause of bacterial pneumonia and meningitis in the US.  It is also a major cause of bloodstream infections and ear and sinus infections.

ABR Bacterial Infection Costs the Healthcare System

Patients with antibiotic resistant (ABR) bacterial infections have higher mortality rates (almost twice) as compared to patients with susceptible infections.  The average length of hospital stay is longer by 6.4 to 12.7 days for patients with ABR bacterial infections.  The longer hospital stays increases direct costs by $18,000 to $80,000 on average.  35% of patients infected by ABR bacteria in the hospital are readmitted within one year with a median time of 27 days.

Appropriate treatment within 24 hours of diagnosis can:

  • Reduce mortality rate and improve patient outcomes
  • Reduce re-admission rates
  • Reduce hospitalization costs by reducing length of stay

CMS Driving Change

Centers of Medicare & Medicaid Services (CMS) is now penalizing hospitals for some hospital-acquired infections (HAIs) and readmission for pneumonia and COPD.  In 2017, CMS penalties for 2600 hospitals will be approximately $528 million for readmission.  Approximately, 60% of HAI patients are insured through CMS.

Lost Hospital Income from Resistant Bacterial Infections

Hospital-acquired infections (HAI) account for $56B of lost income annually for hospitals.

  • Unreimbursed cost – $10B
  • Opportunity cost – $46B

Approximately 70% of HAIs are caused by antibiotic-resistant bacteria, leading to longer lengths of hospital stay for treatment.