According to the largest review of the drug resistance problem to date, by 2050 the annual global death toll from antibiotic-resistant disease will reach 10 million.¹ At present, an estimated 23,000 Americans die each year from drug-resistant infections, and the death toll will continue to rise until or unless the underlying causes are properly addressed. One significant driver of antibiotic-resistant bacteria is the routine use of antibiotics in agriculture.²

As noted by the Institute for Agriculture and Trade Policy in 2016,³ “The rapid spread of new disease strains … is one very visible reason why the expansion of factory-style animal production is viewed as unsustainable.” In the video above, the late Steve Wing, former associate professor and epidemiologist at the University of North Carolina at Chapel Hill, discusses the human health impacts of factory farms.

Another major contributor to and source of drug-resistant infections is hospitals. According to statistics by the Centers for Disease Control and Prevention (CDC), 1 in 25 patients now contracts a hospital-acquired infection⁴ and many of them are resistant to drug treatment. Most disturbing of all, some infections are now exhibiting “panresistance,” meaning they’re resistant to every antibiotic in existence.

One particularly nasty panresistant bacterium that is gaining ground is carbapenem-resistant enterobacteriaceae (CRE), which produces an enzyme that breaks down antibiotics. Hospitals are the most common source of this infection, which is lethal in about 9 percent of all cases. When the CRE infection affects the blood, the death rate jumps to 50 percent.⁵

CRE With Rare New Resistance-Conferring Genes Found in 27 States

Tests conducted last year on nearly 5,780 antibiotic-resistant bacterial samples collected from hospitals and nursing homes revealed 1 in 4 samples contained genes known to confer drug resistance, and 221 contained a particularly rare drug-resistance gene that confers a very high level of resistance.^6,7 Principal deputy director of the CDC, Dr. Anne Schuchat, told CNN she was “surprised by the numbers found.”⁸

The 221 samples came from 27 different states, which shows this particularly troublesome drug-resistance gene has already spread far and wide. It was also found in a number of different types of infections, including samples of pneumonia, bloodstream infections and urinary tract infections.

Disturbingly, follow-up screening showed nearly 1 in 10 asymptomatic contacts tested positive for drug-resistant bacteria carrying this rare gene, which means it can, and likely has, spread to other patients who have come into contact with an infected individual.

To get ahead of the antibiotic-resistance problem, the CDC has created a strategy to identify, track and contain the germs and, according to the CDC, it seems to be working. CRE prevalence has declined slightly in recent years, but the emergence and rapid spread of this new drug resistance gene is still deeply troubling. According to Schuchat, “these verge on untreatable infections,” where supportive care is the only option.⁹

With intravenous (IV) fluids, you may be lucky enough to recover as long as your immune system is strong enough. Still, what in the past might have been an easily treatable condition can now become truly life-threatening.

As noted in the CDC’s report,¹⁰ “Notably, 221 isolates with non-KPC [Klebsiella pneumoniae] carbapenemases were identified; these rare forms of resistance have the potential to add to the U.S. CRE burden and represent an important opportunity to prevent the spread of novel resistance at its earliest stage. Findings from these enhanced prevention efforts are being used to further refine detection and prevention strategies.”

Using Lactated Ringer’s Solution Rather Than Saline Can Save Lives

An important side note on the use of IV fluids is to make sure you or your loved one receives lactated Ringer’s solution rather than saline. Two recent studies show IV saline can cause major kidney problems and death — risks that could easily be lowered by using lactated Ringer’s solution, a “balanced crystalloid” electrolyte replenishment¹¹ that has been widely available for many decades, and costs about the same as saline.

While saline consists of sodium chloride dissolved in water, lactated Ringer’s¹² solution contains a mix of electrolytes, including sodium chloride, sodium lactate, calcium chloride and potassium chloride, which makes it more similar to blood plasma. The first study,¹³ which evaluated outcomes in over 15,800 intensive care unit (ICU) patients, found those receiving IV saline suffered higher rates of kidney problems and mortality within 30 days than those receiving lactated Ringer’s solution:

15.4 percent of those receiving saline had a major adverse kidney event, compared to 14.3 percent of those receiving lactated Ringer’s

2.9 percent of those receiving saline required kidney-replacement therapy, compared to 2.5 percent of those receiving lactated Ringer’s

11.1 percent of the saline group died within 30 days, compared to 10.3 percent in the lactated Ringer’s group

The second study¹⁴ involved adults with noncritical illness who were treated in the emergency room (ER) and subsequently hospitalized outside an ICU. The primary outcome of this one was hospital-free days after discharge. Secondary outcomes included kidney problems, renal-replacement therapy, persistent renal dysfunction and death from any cause within 30 days. Of the nearly 13,350 patients enrolled, 88.3 percent received lactated Ringer’s exclusively in the ER.

Here, the number of hospital-free days were identical in both the saline and lactated Ringer’s groups (with a median of 25 days respectively), but those receiving lactated Ringer’s had a lower rate of adverse kidney events — 4.7 percent versus 5.6 percent. Overall, these two studies suggest lactated Ringer’s solution is particularly important for critically ill patients, but will also lower the odds of adverse kidney events in those who are not critically ill.

While the overall difference in adverse events and death between the two solutions is only about 1 percent, this difference still translates into anywhere from 50,000 to 70,000 fewer deaths and 100,000 fewer cases of kidney failure in the U.S. alone when you consider the tens of millions receiving IV saline each year. So, whenever you’re in the hospital for any significant length of time and need to receive IV fluids, it is imperative to be sure to ask for lactated Ringer’s solution.