The rise of superbugs — microbes resistant to some of the most powerful modern drugs — has public health officials scrambling for a solution.
But the current state of affairs is worrisome, with Dr. Matthew McCarthy, an infectious disease specialist, painting an alarming picture in his new book, “Superbugs: The Race to Stop an Epidemic.”
“There are more superbugs, fewer treatment options and fewer people who know how to treat them,” McCarthy, an assistant professor of medicine at Weill Cornell and a staff physician at New York-Presbyterian Hospital, told TODAY.
The World Health Organization predicts drug-resistant infections could cause 10 million deaths a year — more lethal than cancer — by 2050 if no action is taken.
But McCarthy doesn’t believe that worst-case scenario will happen. Here’s what he wants people to know now:
What is a superbug?
McCarthy: It’s actually a very controversial term. It has traditionally referred to drug-resistant bacteria, but we now know that there’s a much more broad definition: It’s a drug-resistant bacterium, fungus, parasite or even a virus.
Where are people exposed to superbugs?
McCarthy: They are everywhere. It used to be that superbugs were only in discrete areas — MRSA was thought to only be in gymnasiums and nursing facilities. Now we know that they are literally everywhere. Up to 5% of healthcare workers carry MRSA in their nostrils.
The important thing to recognize is superbugs could live on your skin for years and never cause a problem because you have an intact immune system and skin that protects you. Just because something is a drug-resistant microbe doesn’t mean it’s going to cause an infection in you.
People who get into trouble tend to be those who have a weakened immune system. But many people don’t know they have a medical condition that alters how their body fights invaders, or they don’t know they’ve been put on a medication that can wipe out their immune system.
What can people do to find out if they’re at risk?
McCarthy: The first starting point is to ask your doctor: How is my immune system?
Knowing the answer can lead people to understand that maybe they shouldn’t go into a moldy basement or they shouldn’t be diving into a fresh water pond — places where there could be superbugs.
Where in the body are the most common superbug infections?
McCarthy: The skin, the abdomen, the lungs, and we now see a lot of emerging superbugs in urinary tract infections.
Many of the oral antibiotic treatment options for UTIs are now failing, which means that if you go to the hospital you may find out that you have a very treatable urinary tract infection, but the treatment is an intravenous antibiotic and you may have to be hospitalized and get an IV for three days.
That’s not a lethal condition, but it’s going to inconvenience you substantially.
The infections aren’t always difficult to treat. If you have a superbug that’s resistant to nine different antibiotics, but it will be killed by one antibiotic, then I’ll just use that one antibiotic and kill it.
The problem is when you run into bacteria that are resistant to every single antibiotic. I’m increasingly encountering patients for whom there are no antibiotic options and we have to resort to a pre-antibiotic era treatment, which is surgery where we’re just cutting the infection out. It’s a very inelegant approach.
But powerful antibiotics come with powerful side effects?
McCarthy: We’ve seen many cases where we put patients into kidney failure by treating an infection with a toxic antibiotic.
I had a patient who has a superbug infection and the only drug we could use was a drug that fell out of favor 20 years ago because it was so outrageously toxic. But it’s one of the drugs that still works against some superbug infections because it functions like a detergent. It can wash away these dirty bugs.
Is the superbug problem getting worse?
McCarthy: The more we use antibiotics, the more superbugs have been created, and we’re misusing antibiotics.
For example, if the doctor says to take seven days of an antibiotic and you only take two days, that allows the bacteria to mutate because not all of them will be killed, so they can become superbugs.
We use drugs to treat syphilis and tuberculosis in orange groves because it protects the crops, but the soil in that area is rich with superbugs. We also use antibiotics for meat-producing animals like pigs, chickens and cows, and their meat has superbugs.
We’re at this inflection point where suberbugs are expanding and the pharmaceutical industry is losing interest in making new antibiotics because they’re not always profitable. That couldn’t come at a worse time. It’s not just that there are more superbugs out there, but the treatment options are dwindling.
Your local hospital may not have the newest antibiotics — why not?
McCarthy: I work at one of the best hospitals in the world and we don’t carry many of the newest antibiotics that have been approved. The reason is companies that make antibiotics invest so much in them that when they finally get approved, they charge exorbitant prices for them.
An infection does not make the hospital very much money so they don’t have as much of a budget to buy these new antibiotics. That’s something people don’t realize.
It’s very risky and so the FDA has proposed that hospitals should have a subscription service for these antibiotics, kind of like Netflix, where you spend a certain amount each month for the right to have access to all of them.
Why is there a shortage of superbug specialists?
McCarthy: It’s one of the lowest-compensated fields in medicine. Fewer medical students and residents are going into this field because they don’t want to make less money.
To find infectious disease specialists near you, search online or check with the Infectious Disease Society of America.
Is phage therapy a viable option?
McCarthy: The exciting part is that it can target a specific superbug, but the challenge is going to be figuring out how to bring phage therapy to the masses.
You treat people with superbugs — are you scared you’ll get infected?
McCarthy: No, I’m not. We have very strict protocols to protect both patients and doctors from the superbugs in our environment. I have two young children and when I come home from work and I give them a hug, I’m not worried I’m transmitting anything to them.