Another deadly infection blights the US yet again, this time in California.
We all saw the news of the outbreak of carbapenem-resistant Enterobacteriaceae (CRE) at UCLA’s Ronald Reagan Medical Center. The origin stemmed from duodenoscopes used at that hospital. This closely follows on the heels of the measles ( a virus previously considered eradicated from the US) outbreak that occurred earlier this year stemming from Disneyland. Last year, for the first time in history, patients contracted Ebola in our country.
Our battle against infectious diseases apparently took a step back in the 21st century.
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The discovery of penicillin has long been heralded as one of the greatest developments in medicine. Since its use became wide spread, people live longer and survive infections that used to kill them. So, why are we experiencing an apparent step- back.?
Perhaps, the biggest danger facing us arises from super-infections (superbugs as they are otherwise known) and the increase in antibiotic resistance we are now seeing. Antibiotic over-prescription allows some of this to happen. When an antibiotic is given to treat a patient when it is not needed, then that antibiotic loses its power to treat future infections. It is imperative that doctors and other healthcare workers do a better job educating their patients on when antibiotics are indicated and when they are not. Patients should be aware of this superbug threat and everyone holds some responsibility in overcoming it.
Another big concern is that no new antibiotics or class of antibiotics have been developed over the past several years. We are failing to cure infections with antibiotics the way we used to be able to do so. A great example of this is the rise of MRSA. This infection used to just be found in hospitalized patients but it is now commonly seen in the community setting. This infection often requires 2 or 3 antibiotics to eradicatae it. More research is clearly needed to discover newer and more creative tools for fighting these diseases.
One of our most powerful tools has been cast aside by many. Since, the wide-spread use of vaccines became standard, countless lives have been saved and hospitalizations avoided. However, many are now choosing to forgo vaccines and vaccinating their children. They cite many reasons for doing so, much of it based on false science. Here too, we, as doctors, need to do a better job getting accurate information out to the public. Also, we need to hold responsible those doctors preaching false information about vaccines. As physicians, the expectation is that we practice evidence based medicine and follow a certain standard of care. Doctors who fail to do this need to be held accountable. Children die from this false information.
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The Ebola crisis taught us all a big lesson. It showed us that we are not so prepared to handle new and rare infections. And we see many new infections springing up globally, such as MERS and chikungunya virus. We need to develop protocols for treating these diseases. And every part of the healthcare team needs to be aware. It is not enough for the CDC to issue alerts to hospitals. Every member of the healthcare team needs to know what protocol to follow.
The 20th century brought great strides in our fight against infections, from new vaccines, antibiotics, cleaner water and environmental standards, and many more developments. Now, we are seeing a step back from these discoveries. Unless we address these problems, we will lose some of our ability to fight off infections. Everyone has a role here. Drug companies need to develop new therapies, doctors should prescribe antibiotics only when clearly indicated, and patients need to be educated about all of these things. Who wants to return to the 20th century pre-antibiotic and vaccine days?
