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Diseases That Never Went Away: Battling Drug Resistance


Until recently in this country, tuberculosis was thought to be a thing of the past. But new outbreaks of TB in Michigan and Virginia are raising alarm bells, and not just because TB's a nasty disease. These new strains are increasingly resistant to antibiotics.

To find out more about the expanding threat of drug-resistant bacteria, we turn to Dr. Tom Frieden, director of the Centers for Disease Control in Atlanta, Georgia. Dr. Frieden, welcome to the program.

DR. TOM FRIEDEN: Great to be here.

LYDEN: Why are we seeing a reemergence of the illnesses that many of us thought were historical by now and something that belonged to the 19th century like tuberculosis?

FRIEDEN: In fact, they never went away. What went away was our attention to them. We've had tuberculosis killing more than a million people around the world forever, really. And now the challenge is that we're able to identify the problem. We're able to see how much multidrug resistant tuberculosis is being created and spread, and how many people are suffering as a result. And really, it emphasizes that we're all connected by the air we breathe, by the water we drink, by the food we eat. And improving disease control around the world is really important not only ethically but also in our self-interest.

LYDEN: Have these viruses and bacteria become drug resistant?

FRIEDEN: Unfortunately for some bacteria and some patients, we are in a post-antibiotic era where every antibiotic we have doesn't work. We estimate at CDC that about half of all the antibiotics prescribed to patients are either unnecessary or inappropriate. So part of what we need to do is improve our stewardship of the antibiotics we have so we can preserve them for as long as possible.

LYDEN: Let's talk about another class of drug-resistant bacteria. And that is something called CREs. Let's explain what CREs are and why they're so dangerous.

FRIEDEN: CREs I've called a nightmare bacteria. That's because not only are they resistant to just about every antibiotic we have, but they can spread their resistance to many different organisms - not just one type of organism, but several types of organisms. And all of those different types of organisms are potentially quite deadly. Currently, they're largely limited to hospitals. But if they spread to the community, it's going to make it extraordinarily difficult to treat common conditions such as a urinary tract infection. If we don't stop it now, we're going to be in much more trouble going forward.

LYDEN: Dr. Frieden, if these CREs are mutating into a drug-resistant pattern, how do you stop them, or can you?

FRIEDEN: Our approach with CREs specifically is detect and protect - find patients who have the organisms and isolate them from others. We've seen, for example, in Florida hospitals, a decrease in CRE over time when the detect and protect strategy was used.

LYDEN: So are you hopeful about managing them?

FRIEDEN: I'm optimistic. We've got new tools. We can diagnose resistance in hours for some organisms instead of days. We've also got more commitment from hospitals in the U.S., from leaders around the world to identify and stop drug resistance. And one thing we do know is it's possible to turn this around. I'm confident we'll do that.

LYDEN: That's Dr. Tom Frieden, director of the CDC in Atlanta. Thank you so much and stay healthy.

Thank you. Transcript provided by NPR, Copyright NPR.