Antibiotic-Resistant Bacterial Infections: The Nightmare of Cancer Patients

Before I returned to Taiwan to establish the nation's first specialized cancer hospital, I had already spent 25 years in the United States caring for cancer patients. I am aware that whether due to the cancer itself or the effects of chemotherapy and radiation therapy, cancer patients often suffer from weakened immune systems. If infection control within the hospital is not stringent, many cancer patients die not from cancer but from sepsis during treatment. Thus, preventing infections is an extremely important aspect of cancer care.

Actively Avoiding Cross-Infection Among Patients

Therefore, in addition to hiring enough infectious disease specialists and actively practicing infection control, to prevent cross-infection via shared bathroom facilities and toilets, my initial plan for the cancer hospital wards was to have one room per patient. Furthermore, to eliminate economic barriers for underprivileged patients, a subsidy fund was prepared to help all patients reduce the chance of cross-infection.

I believe that having patients who can afford it pay a little more for private rooms, free from disturbance of others, not only allows them to rest properly but also reduces the risk of infection, leading to a smoother recovery. Conversely, if infection occurs and antibiotics are required, the extended hospital stay increases the costs of medical care and hospitalization. Patients not only suffer from the pain of infection but may also tragically lose their lives.

When national health insurance began, I finally persuaded the Department of Health to allow a maximum of two patients per room in cancer hospitals. Regrettably, in a Taiwanese society accustomed to hospitals crowded like marketplaces, with multiple patients sharing a room, our efforts to ensure patient safety and our investment in hardware and software for infection control have led to the stigmatization of our hospital as a "noble institution" deliberately excluding the common people.

Taiwanese Hospitals Report High Rates of Drug Resistance

A few months ago, a survey by the Infectious Diseases Society of Taiwan uncovered that the drug resistance rate for Klebsiella pneumoniae in Taiwan's medical centers reached 38.4%, with regional hospitals even higher at 48.9%, a rapid increase from the previous year (KFSYSCC reported a rate of 4%). The secretary-general of the society, Dr. Huang Jianxian, stated that Taiwan currently has a shortage of over eight hundred specialists in infectious diseases. The president of the society, Dr. Wang Fude, put it bluntly: “No matter how well a surgery is performed, if the patient contracts a drug-resistant bacterial infection, it's all for naught!”

What he means is that in a hospital, if there are not enough infectious disease doctors, it becomes challenging to manage in-hospital infections and antibiotic use properly. Consequently, hospitalized patients are at a higher risk of contracting drug-resistant bacterial infections. Even if the surgery is successful, patients could lose their lives to these infections, which is a great misfortune.

Recently, the National Cancer Institute in the United States proposed innovative strategies in cancer prevention, diagnosis, and treatment in support of President Biden's Cancer Moonshot initiative, which aims to halve cancer mortality rates over the next 25 years.

In response, infectious disease experts published articles arguing that if the Moonshot initiative lacks strategies to combat drug-resistant bacteria, it simply won't get off the ground.

The authors especially highlight the entanglement of cancer and drug-resistant bacterial infections, describing it as the worst nightmare for cancer patients. The risk of death due to drug-resistant bacterial infections is three times higher for cancer patients than for others. The authors believe that without governmental incentives to develop more effective antibiotics, even numerous innovations in cancer treatment will not achieve the goal of halving the cancer mortality rate in 25 years.

From this, it is clear that proactive prevention of drug-resistant bacterial infections is critically linked to the survival of cancer patients.

Author: Dr. Andrew T. Huang (President/CEO of KFSYSCC)