Of course, the first is the illness and death that results from untreatable infections. But Bill Hanage makes a very important point (boldface mine):

Although the risk of getting a completely resistant infection is low in the United States, about 2 million people each year become infected with “resistant enough” bacteria that are harder to treat, Hanage said. And every year, more than 20,000 people die of these infections.

“More resistant infections don’t just mean you or someone you care about is more likely to die from one, they also mean healthcare will get even more expensive,” Hanage said. “Many of the procedures we take for granted in medicine, from cancer treatments to surgeries, depend on our ability to handle infections that happen in the course of treatment.”

While we focus on life-threatening infections for obvious reasons, there are other consequences of “resistant enough” infections that could become more widespread:

Obviously, CREs present problems for the most serious infections, such as bloodstream infections, but one thing I’ve tried to raise is that CREs, if they become more common, will also create significant problems for urinary tract infections (‘UTIs’). In the best case, it will become much more difficult to get rid of annoying/painful UTIs. But, even in otherwise healthy people, UTIs can occasionally develop into serious infections that can cause long-term kidney damage and death.

Because UTIs often live as gut commensals–like most other E. coli–if CREs were to reach, let’s say, one percent of the total human commensal population, then we would face tens of thousands of essentially untreatable UTIs in the U.S. alone….

While the fight against antibiotic resistance has focused on life-threatening illnesses (for obvious reasons), we must realize that chronic debilitation from UTIs could also be a problem. In terms of raising awareness, deadly infections ring the panic bell, sometimes to the point where many people would rather ignore the problem, but something like UTIs can be used to explain to people how antibiotic resistance can affect their daily lives.

It’s potentially a much broader problem than people commonly realize.