By Mackenna Moralez, Assistant Editor

In a recent episode of Law & Order: Special Victims Unit, a perfectly healthy 24-year-old woman dies after contracting a drug-resistant infection in the hospital. While the death was unexpected and tragic, infections such as this are not entirely uncommon in the healthcare facilities, especially among older patients. Now, a study by Pew Data has found that antibiotic resistance is a growing threat to older patients.

“Even though seniors made up only 15 percent of the U.S. population in 2017, they accounted for 40 percent of all deaths related to six common antibiotic-resistant infections among hospitalized patients,” says David Hyun, director of the Pew Charitable Trusts’ antibiotic resistance project. “Seniors also accounted for 41 percent of health care costs to treat these infections. This amounted to over 11,000 deaths and nearly $1.9 billion in health care costs — costs that likely fell in large part on federal systems like Medicare.”

The study found that the highest mortality rates occurred when patients acquired antibiotic-resistant infections in hospitals, compared to infections acquired in community settings. Between 15and 27 percent of seniors who acquired infections died.

These infections can significantly complicate patient care, especially for older individuals who already have compromised immune systems. All types of healthcare facilities play an essential role in combatting resistance. Hyun says agencies such as the Center for Disease Control and Prevention (CDC) help provide funding to better support facilities' efforts to prevent antibiotic resistance and mitigate the harm once they emerge.

“Unfortunately, the reality is that resources like staffing and funds in many health care facilities—especially during the pandemic, which stretched many facilities like hospitals extremely thin—are limited,” Hyun says. “That puts a real strain on facilities that are trying to deliver the highest quality of care possible to their patients while juggling a lot of priorities. This is why it’s crucial for the federal government to invest in public health by supporting health care facilities so they can do the essential work of improving antibiotic use, managing infection prevention programs, and conducting disease surveillance.”

Infection prevention programs play a central role in containing spread within facilities when infections emerge. These types of programs help reduce patient-to-patient infection spread and patient-to-worker spread. Another way to better fight off these infections is for federal agencies to enact measures to improve antibiotic prescribing in order to create new drugs, Hyun says.

“Congress also has a role to play in protecting seniors, and all Americans, from these infections,” Hyun says. “The first way policymakers can do this is by ensuring adequate funding for federal agencies on the front lines of public health like the CDC, so they can support facilities in implementing antibiotic stewardship programs, improving prescribing, and slowing the spread of resistance. And secondly, Congress can enact legislation like the PASTEUR Act that would help fix the broken antibiotics market and drive the development of urgently needed new drugs that work against resistant pathogens.”

While the study did not cover the COVID-19 pandemic, there are warning signs that the virus is accelerating its antibiotic resistance. In March, Pew Data found that many hospitalized COVID-19 patients in the United States were prescribed antibiotics despite not having bacterial infections that would respond to these infections. In 2020, U.S. hospitals saw a rise in healthcare- associated infections because of the pandemic, according to Pew Data.

While the pandemic’s impact on antibiotic resistance has yet to be fully seen, Hyun says infection control managers should not slow down efforts to combat the threat.

“I can’t emphasize enough the importance of combatting antibiotic resistance,” he says. “Infections that don’t respond to existing antibiotics put much of modern medicine at risk, and they make basic procedures we take for granted — like hip replacement surgeries and medical device replacements — far more dangerous. We need to do everything within our power to slow the development of drug-resistant pathogens and keep patients safe.”