'Superbugs' Are Surging and So Is Antibiotic Resistance

Antibiotic resistance and the development of “superbugs” are on the rise since the COVID-19 pandemic. Not only is the number of people infected with superbugs increasing, more types of germs are becoming resistant to treatment.

So how are healthcare experts combatting the latest wave of antibiotic-resistant superbugs? University Hospitals Director of Antimicrobial Stewardship Leila Hojat, MD, explains the strategies infectious disease specialists are using to catch up to superbugs after COVID.

What is a Superbug?

“Superbug” is a term used to describe pathogens – bacteria, fungi or other microscopic organisms – that are resistant to many of the standard antibiotics used to treat infections.

“Generally, when we treat certain infections with antibiotics, they will work for some time but the bug will find ways to change or mutate so that it no longer works; it finds a way around the antibiotic,” says Dr. Hojat.

Antibiotic resistance can develop in a single person – when some of the bacteria survive an antibiotic, those bacteria get smarter and take over. It can also be transmitted from one person to another, especially in a hospital or healthcare setting.

Superbugs in the Age of COVID

The rise of antibiotic resistance can be traced back to the overuse of antibiotics. For decades, people have taken antibiotics for everything from minor infections to things like colds or the flu – which are caused by viruses, and therefore are not affected by antibiotics.

While healthcare experts had come a long way in combatting the over-prescription and overuse of antibiotics, the pandemic was a setback, says Dr. Hojat. In the early days of the pandemic, when there were few available treatments, doctors gave COVID patients antibiotics to treat their symptoms. In addition, resources had to be reallocated toward COVID care, and hospitals couldn’t always keep up with non-COVID-related infection control.

Common Superbugs and How They’re Treated

Superbugs can evolve from a variety of pathogens, creating antibiotic-resistant strains of common infections. A recent example is Candida auris (C. auris), a potentially deadly fungus that has been detected in 28 states in the last 12 months, including Ohio. C. auris is resistant to many of the most common treatments and is difficult to identify with standard lab testing. Like other superbugs, C. auris is most likely to spread in healthcare settings such as hospitals and nursing homes, where patients may be more susceptible to infection.

Treating a drug-resistant superbug is usually a matter of finding the right antibiotic, says Dr. Hojat. Thankfully, many new antibiotics have come into the market in the last decade or so, giving doctors more options for treating infections. However, occasionally an infection will become resistant to even the strongest, most specialized antibiotics. In these hard-to-treat cases, phage therapy is another option that has shown success in recent years. This therapy involves using viruses – called bacteriophages – to fight bacterial infections.

Preventing Infection and Antibiotic Resistance

Dr. Hojat said that you shouldn’t be overly concerned about the spread of superbugs at an individual level, especially if you are healthy. But some precautions you can take include:

• Avoid the overuse of antibiotics: One of the best ways to decrease the chance of developing antibiotic resistance. Avoid taking antibiotics for viruses or if you don’t have any symptoms. When you are prescribed antibiotics, follow instructions closely and take all of the antibiotics prescribed, even when you are feeling better.
• Follow infection control strategies: This includes things like regular hand washing, keeping surfaces clean and disinfected, and staying on top of current public health guidance.
• Get vaccinated: One of the best ways to prevent common infections is to stay up-to-date on all your recommended vaccinations.

In hospitals, infection control experts are fighting antibiotic resistance and superbugs by following strict hygiene protocols. Another important strategy includes creating guidelines for physicians to prevent antibiotic overuse – when to prescribe, what to prescribe and for how long.

“COVID was a setback at least for some of the superbugs, but it also taught us a lot,” says Dr. Hojat. “Now we’ve caught up and we’re on the path to reducing antibiotic resistance in the hospital and the community.”