The threat posed to public health by antibiotic resistant bacteria has been well known since the early 1990s however recent reports in the media of potential discoveries of new drugs has given hope that the threat is being mitigated, if not resolved. This is an unduly optimistic and premature belief.
The recent report on Antimicrobial Resistance (AMR) to the UK Prime Minister in December 2014 highlighted that antimicrobial resistant infections currently claim over 50,000 lives each year across Europe and the United States alone. In 15 European countries more than 10% of bloodstream Staphylococcus aureas infections are now caused by methicillin-resistant strains (or MRSA) with some countries now approaching 50%. Drug-resistant tuberculosis prevalence amounted to 480,000 new cases in 2013 worldwide and reported cases of drug resistant malaria have started increasing in South East Asia particularly in Myanmar and Thailand. The death toll from drug resistant malaria is only available as a vague estimate of between 10,000 and 200,000 people worldwide, mainly children. The tough gut-bacteria known as Enterobacteriaceae of which the best known is Escherichia coli (or E-coli) have also been found to have drug-resistant strains. In the United States, currently 4% of Enterobacteriaceae are drug resistant and in Greece it has reached 68% for the strain of Klebsiella.
The recent report on Antimicrobial Resistance (AMR) to the UK Prime Minister in December 2014 highlighted that antimicrobial resistant infections currently claim over 50,000 lives each year across Europe and the United States alone. In 15 European countries more than 10% of bloodstream Staphylococcus aureas infections are now caused by methicillin-resistant strains (or MRSA) with some countries now approaching 50%. Drug-resistant tuberculosis prevalence amounted to 480,000 new cases in 2013 worldwide and reported cases of drug resistant malaria have started increasing in South East Asia particularly in Myanmar and Thailand. The death toll from drug resistant malaria is only available as a vague estimate of between 10,000 and 200,000 people worldwide, mainly children. The tough gut-bacteria known as Enterobacteriaceae of which the best known is Escherichia coli (or E-coli) have also been found to have drug-resistant strains. In the United States, currently 4% of Enterobacteriaceae are drug resistant and in Greece it has reached 68% for the strain of Klebsiella.
Research from the United States has found that drug resistant bacteria from cattle has been able to become airborne and move distances for further contamination.
Without effective prophylactic antibiotics to reduce infections, many surgical procedures would become too risky to undertake. Four areas of high-volume medical intervention would particularly be affected: caesarean sections for births; joint replacements; cancer surgical treatment; and organ transplants. In effect modern medicine would be plunged backwards into the pre-antibiotic period.
And what are the causes of this growing health crisis ? Drug development is less than half the problem with over-prescribing/misuse of antimicrobials, and counterfeit/sub-standard drugs being sold over the counter without a prescription being major culprits, particularly in developing countries such as parts of Africa, India, Pakistan and Bangladesh. Researchers have found drug-resistant Enterobacteriaceae in street puddles in Delhi, India and in water samples taken in Pakistan and Bangladesh. Although infection control in hospitals can provide short term solutions, the fundamental need for new discoveries, faster pathways for antibiotics to be available and stricter management of drug access and use remains the pivotal changes needed.
The link to the research findings for Teixobactin is at the link below:
Great piece Charles, you are so right. One day a drug-resistant infection will spring up in the West (as Ebola did in Africa) and everyone will say, 'why weren't we told?'
ReplyDelete