Dr. Reed Post.Antibiotics.11.30.11

Dr. Reed Post.Antibiotics.11.30.11 - Infections in the...

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Unformatted text preview: Infections in the Post-Antibiotic Era Sharon Reed, M.D. Professor of Pathology and Medicine Director, Microbiology and Virology Laboratories World ʼ s Deadliest Infectious Diseases Infectious Disease Cause Deaths per Year Respiratory Inf. Bacterial or Viral 2.7 million AIDS Viral 2.1 million Diarrhea Viral or Bacterial 1.5 million Tuberculosis Bacterial 1.0 million Malaria Parasite 0.96 million Hepatitis B Viral 0.52 million Measles Viral 0.45 million http://www.who.int/mediacentre/factsheets/fs310/en/index.html Trends in Deaths Caused by Infections Diseases in the U.S 200 400 600 800 1000 Mortality Rates/ 1 00,000 Population 1900 1925 1950 1975 2000 Year Infectious Disease Mortality in U.S. Causes of Death in Ages 25-44 http://www.cdc.gov/nchs/hus.htm Emerging Infections Factors Favoring Emergence of New Agents • Microbial adaptation and change – Antibiotic resistance – Genetic flexibility: Influenza • Human Susceptibility to Infection – Immunosupression from transplantation and AIDS – Malnutrition Increasing Number of Transplants 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Year Number of Donors Deceased Donor Living Donor 8022 6722 Source: UNOS Factors Favoring Emergence of New Agents • Climate and weather – Dengue following hurricanes • Changing ecosystems – Deforestation • Economic development and land use – Humans into contact with animals: HIV Factors Favoring Emergence of New Agents • International travel and commerce – Food from developing countries – Hepatitis A in frozen school strawberries • Technology and industry – Antibiotics in animal feed – Organ and xenotransplants • Breakdown of Public Health Systems – Polio in Nigeria – Cholera in Haiti Factors Favoring Emergence of New Agents • Poverty and social inequality – Access to clean water and food – Medical care • War and famine – Leishmania from Iraq • Lack of political will – AIDS in S. Africa • Intent to harm Emerging Infections • Bacterial: Antibiotic Resistance – Methicillin-resistant Staphylococcus aureus – Vancomycin-resistant Enterococcus • Parasitic: Cryptosporidiosis • Viral: Influenza Use of Anti-Infectives • 2500 B.C. Chinese used moldy soybean curd for boils and other infections • Greek physicians, including Hippocrates used antimicrobial substances such as wine, myrrh • 1900’s heavy metals such as arsenic for syphillis • 1936 Sulfonamides • 1950’s Penicillin and Streptomycin Bacteria and Resistant Genes Source: Levy S . The Challenge of Antibiotic Resistance, Scientific American, 278(3):48 . LR Antibiotic-Resistant Bacteria Source: Levy S . The Challenge of Antibiotic Resistance, Scientific American, 278(3):48....
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Dr. Reed Post.Antibiotics.11.30.11 - Infections in the...

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