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Are Deadly Infections an Indicator of Worse to Come?
Doctors and hospitals are increasingly sobered by deadly new strains of "superbugs" that are largely invulnerable to today's most potent antibiotics. Is it possible we could we see epidemics of incurable infections?
Source: Thinkstock
A strain of antibiotic-resistant bacteria known medically as carbapenem-resistant enterobacteriaceae, or CRE, has jumped to the forefront of the medical world's attention due to one very disturbing fact—their near-total resistance to an entire family of drugs known as carbapenum antibiotics makes them nearly impossible to treat once they infect a patient.
Emerging recently in hospitals and nursing homes, they attack the most vulnerable—weaker and elderly patients. And once they get a foothold in a hospital or nursing home, they are virtually unstoppable.
In the face of these and other rising health threats on a national and global scale, we need to consider what's happening and where our primary focus should be.
"Nightmare superbugs"
No less an authority than the renowned Centers for Disease Control and Prevention refers to these lethal bacteria in terms not normally used in the staid medical world. CDC Director Dr. Thomas Frieden, in a March 6, 2013, USA Today story, says these "nightmare superbugs" present a triple threat. "They're resistant to nearly all antibiotics. They have high mortality rates, killing nearly half of people with serious infections. And they can spread their resistance to other bacteria," Frieden said.What worries Dr. Frieden and so many others is that antibiotics known to the medical world today have virtually no effect on these superbugs. He and other bacteriologists fear it may be too late to stop their onslaught, which has killed up to 70 percent of patients infected by CRE. Doctors fear they are running out of options to slow or stop the spread.
Friedan warned that the United States has only a "narrow window of opportunity" to take action before it is too late to halt the spread of the bacteria. He envisions a scenario in which antibiotics could become powerless against such common ailments as diarrhea and respiratory and urinary tract infections.
Thus far, CRE infections have been reported in 42 states. As of late last year, about 4 percent of U.S. hospitals had reported at least one case of CRE infection, with that rate jumping to 18 percent among acute-care hospitals.
Even such renowned facilities as the National Institutes of Health's Clinical Center near Washington, D.C., are not immune. Last summer a CRE strain struck the center where it killed seven, including a 16-year-old boy. And there have been worse outbreaks.
Intensive care patients seem to be at the greatest risk, especially those on ventilators or hooked up to central intravenous catheters. Organ transplant patients and those undergoing chemotherapy seem particularly vulnerable. And health officials fear that continued mutation of CRE bacteria could produce varieties that could make even common infections virtually untreatable.
We report this not to dissuade readers from seeking needed medical care, but to increase awareness of the problem. All of us must consider what's happening in the world and exercise wisdom.
Unexpected effects stymie experts
What has brought this alarming state of affairs?Medical observers have noted that the overuse of certain antibiotics in hospitals and nursing homes has had an unexpected effect: Many of the Enterobacteriaceae have become resistant to most of the antibiotics in general use today. As a result, where just over a decade ago only 1.2 percent of bacteria were antibiotic-resistant, today that number has grown to about 4.4 percent. Ironically, the bugs have become resistant to the very carbapenum antibiotics developed as an answer to weaker earlier antibiotics.
"This has been bred in hospitals and nursing homes because of the way we use antibiotics," said Dr. Carlos Nunez, chief medical officer for CareFusion, a company which markets an infection surveillance system used in many hospitals. "You go to a place where you are supposed to get better and you get an infection where you have a 50 percent chance of dying. It's a nightmare scenario."
The pathogens'ability to survive and become resistant to antibiotics has stymied medical experts. Overuse of antibiotics to kill CRE in past years has produced strains of drug-resistant germs that not only survive, but are able to pass along survival traits to other bacteria found in hospitals.
The growing alarm over the CRE threat has placed hospitals and nursing homes on the defensive. CRE can be transferred from patients to the environment and to the hands of the care providers, such as doctors or nurses, when care providers touch patients or touch them with medical equipment, then touch other patients. To counter this, stricter enforcement of hand washing has become required practice in medical facilities.
Procedures in many hospitals now call for patients considered high-risk for CREs to get special screenings on arrival. Hospital officials now warn hospital visitors to wash their hands thoroughly and insist that anyone who touches them also wash their hands.
CRE infection of a patient triggers additional precautions to reduce the likelihood of its spread to other patients. Under the use of "contact precautions," patients are essentially quarantined, transferred to separate rooms to which the patient is confined and from which visitors are barred. Nurses and other caretakers can be required to wear gloves and gowns each time they enter the room.
Old diseases on the return
For more than a century, America and the Western world have made what seemed to be unstoppable progress on the road to eradicating sickness and disease. One by one through the decades, such dreaded maladies as smallpox, yellow fever, whooping cough and tuberculosis began to disappear as medical research discovered their causes and ways to prevent them.The 20th century featured a parade of medical advances. One by one, diseases that plagued mankind for centuries fell before the advances of medical science.
Major milestones were the discovery in 1900 of the cause of yellow fever by two U.S. Army doctors, Walter Reed and James Carroll. The 1920s saw the development of vaccines for whooping cough, diphtheria and tuberculosis, and the uses of insulin to treat diabetes. Dr. Jonas Salk astounded the medical world in 1955 with his discovery of a vaccine to prevent polio, which had paralyzed millions. Vaccines for measles, mumps and rubella followed in the 1960s, as did heart and other organ transplants.
And while some diseases, such as cancer and heart disease, have not been stopped, medical science has made great strides in treatment. Survival rates for cancer have improved tremendously since 1960.
A 2009 survey in the United Kingdom showed five-year survival rates for leukemia, prostate, melanoma and several other common cancers to be as high as 84 percent. U.S. five-year survival rates for bladder cancer are as high as 80 percent, and more than 50 percent for lung cancer. Aggressive treatments such as chemotherapy and radiation, and surgery as a last resort, have resulted in cures or partial cures for millions.
But are we now beginning to see a reversal of that trend? Are we starting to lose ground, even retreat, in the face of illnesses where bacteria and other microorganisms mutate to the point they become resistant to the vaccines and antibiotics of modern medical science?
Tuberculosis, once thought to be nearly eradicated, is making a comeback among some sectors of the U.S. population, according to series of recent reports. A current CDC fact sheet reported on the rise of "multi-drug resistant tuberculosis," which seems to be on the rise among many immigrant groups.
These strains of TB have developed resistance to all of the most effective TB drugs, leaving patients the only option, in the bland wording of the report, "to pursue treatment options that are much less effective."
Once thought to be eradicated, scarlet fever has recently been found to be on the increase. The discovery of penicillin in 1943 did much to virtually eliminate the disease, which ravaged America in the 18th and 19th centuries in massive outbreaks. But a new, more virulent form resistant to penicillin has arisen, and outbreaks have occurred in China, where reported cases tripled in 2011. A flurry of new cases broke out in Michigan last year, concentrated among immigrant communities.
Where is our trust?
It's time that all of us start doing some serious reflection and assessment. We might ask whether we've taken modern "wonder drugs" for granted, assuming that science will always find a solution for our problems. Does your Bible have anything to say about this?Notice the words of Moses to ancient Israel: "If you do not carefully observe all the words of this law that are written in this book . . . then the Lord will bring upon you and your descendants extraordinary plagues—great and prolonged plagues—and serious and prolonged sicknesses . . . all the diseases of Egypt . . . Also every sickness and every plague . . . will the Lord bring upon you until you are destroyed" (Deuteronomy:28:58-61 [58] If thou wilt not observe to do all the words of this law that are written in this book, that thou mayest fear this glorious and fearful name, THE LORD THY GOD;
[59] Then the LORD will make thy plagues wonderful, and the plagues of thy seed, even great plagues, and of long continuance, and sore sicknesses, and of long continuance.
[60] Moreover he will bring upon thee all the diseases of Egypt, which thou wast afraid of; and they shall cleave unto thee.
[61] Also every sickness, and every plague, which is not written in the book of this law, them will the LORD bring upon thee, until thou be destroyed.).
Moses also warned of incurable illnesses as punishment for national sins earlier in this passage: "The Lord will strike you with the boils of Egypt, with tumors, and with the scab, and with the itch, from which you cannot be healed" (verse 27). That last phrase strikes a familiar chord with our situation today.
Increasingly, medical issues take the forefront of our concerns. Millions in the Western world, especially those entering late middle age and older, spend more time concerned about the effects of illnesses and what will happen if they have to go into a hospital.
But the God who designed and created the human body has some good news for us. He forgives and heals! Of course, this requires turning to Him and following His ways. Still, the timing remains up to Him. In some cases, He will deliver us immediately. But even if He does not completely heal right now—as He knows what is ultimately best for all of us—He nevertheless has a plan in place that will eradicate sickness and disease forever.
Notice this good news in Revelation:21:4And God shall wipe away all tears from their eyes; and there shall be no more death, neither sorrow, nor crying, neither shall there be any more pain: for the former things are passed away.: "'He will wipe away every tear from their eyes. There will be no more death' or mourning or crying or pain, for the old order of things has passed away" (New International Version). And even prior to that, a time is coming when the earth, under the reign of Jesus Christ, will be largely free of pain, sickness and disease. Not only will hospital-born killer germs be eliminated, but there will no longer be a need for hospitals themselves.
If this sounds too fantastic to be true, read the Bible study aids, Why Does God Allow Suffering? and The Road to Eternal Life . You'll find the Bible has much more to say about the scourge of disease.
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