Superbugs threaten us all

November 7, 2023

Up to 37 million Americans have chronic kidney disease, but nine in 10 of them don't realize it. The illness typically causes no symptoms until it reaches advanced stages, which gives the condition its reputation as the silent killer. For around 800,000 Americans with end-stage kidney failure, kidney function is so impaired they must receive dialysis to survive – or a transplant.

Unfortunately, dialysis increasingly exposes patients to another killer: drug-resistant infections, or superbugs.

Antibacterial-resistant infections contributed to nearly 5 million deaths worldwide in 2019. In the United States, superbugs were the third leading cause of death from disease in 2019.

We must act to combat superbugs – and fast. Thankfully, there's a common-sense solution at hand. A bill known as the PASTEUR Act would jump-start the arsenal of new medicines we need to counteract the accelerating superbug pandemic.

Antimicrobial resistance occurs when pathogens like bacteria and fungi evolve to fend off currently available antimicrobial medications. It's hard to overstate how pervasive AMR is. A stunning 92% of urinary tract infections are resistant to at least one antibiotic. Nine in 10 cases of the hospital-associated fungus Candida auris are drug-resistant.

Nobody is immune to superbugs, but certain patient groups are at much higher risk of infection. People with chronic conditions, like kidney disease, or weakened immune systems, are more likely to contract a drug-resistant infection.

According to one CDC study, people on dialysis are 100 times more likely to contract a staph bloodstream infection than those who are not on dialysis. Infection is a leading cause of death among patients on dialysis.

We can't sit idly by as a patient, who has been waiting years for a transplant, contracts a drug-resistant infection that delays their eligibility to receive the organ. Or while a patient on dialysis succumbs to a superbug.

Fighting AMR is within our scientific reach. The problem is that the market for the treatments we need to do so is broken.

To preserve the efficacy of antimicrobials, especially the newest ones, physicians must prescribe them only when they're appropriate for the patient. This careful use – known as stewardship – helps slow the rate of resistance. But it also limits their sales potential, making it nearly impossible for drug developers to sustain through their upfront investments.

Fortunately, the PASTEUR Act would correct this market contradiction by creating a new, alternative payment model for antimicrobials.

The government would enter into contracts with antimicrobial innovators. These contracts would not be based on volume, but rather access to novel treatments. Antimicrobial developers are assured the revenue they need to innovate new treatments, while clinicians focus on using antimicrobials as judiciously as possible.

For the sake of all patients – but especially those with chronic conditions like kidney disease – lawmakers should waste no time passing the PASTEUR Act. It's a smart idea that would put us on the path to outrunning superbugs.

LaVarne A. Burton is the president and CEO of the American Kidney Fund.
  • Cape Gazette commentaries are written by readers whose occupations, education, community positions or demonstrated focus in particular areas offer an opportunity to expand our readership's understanding or awareness of issues of interest.

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