Maintaining microbiome health crucial in fighting antibiotic resistance, CDC says

Focusing on pathogen reduction and treatments that restore beneficial bacteria in a patient's microbiome may be key in the fight against growing antibiotic resistance, a CDC report published May 22 found.

Antimicrobial resistance continues to make the World Health Organization's list of the top 10 threats to global health because of the potential danger it poses to preventing infections. 

In the CDC's new report, researchers note that antimicrobial-resistant bacterial infections can happen if "colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations." When this happens, it can make infection very likely, particularly if "pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense." 

The CDC recommends reducing pathogens by using mupirocin and chlorhexidine as topical decolonization agents and taking a universal approach to pathogen reduction by aiming to reduce them across the hospital — not just around patients already colonized.

An analysis of the universal approach to pathogen reduction in hospitals found that doing so can prevent "up to 40-fold more deaths and up to 30-fold more [bloodstream infections]," according to the CDC.

Doing the above in combination with leveraging the microbiome of patients to protect healthy bacteria in the gut rather than treat with broad-spectrum antibiotics — which can lead to complications like C. difficile infections —  can help reduce resistance. 

Antibiotics disrupt bacteria in the gut, so approaching treatment with live biotherapeutic products is likely to be more beneficial in the fight against antimicrobial resistance, the researchers note.

Future strategies for combatting the threat should focus on multifaceted approaches that include applying the "understanding of ecologic principles to address the pathogen burden in healthcare," which the authors note, "might promote enduring success in driving down infections while preserving the lifesaving utility of available therapeutic drugs."

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