March 11, 2013
Antibiotic-Resistant Superbugs A Growing Global Health Threat
Lawrence LeBlond for redOrbit.com - Your Universe Online
Climate change, terrorism and cyber-crime are all issues that are a dire threat to a nation, and now Britain´s top health official says that “superbugs” should be added to that list. The danger posed by the growing number of bacteria resistant to antibiotics is as dangerous to the country as other top threats.
Professor Dame Sally Davies, chief medical officer for England, warned that routine operations could become deadly in as little as 20 years if doctors and surgeons lose the ability to fight dangerous infections, describing the problem as a “ticking time bomb.”
She is urging the government to raise the issue when it meets at next month´s G8 Summit in London.
Davies said that if we do not find a way to fight back against superbugs now, it may be too late in the future. We may not be capable of providing safe cancer treatments and organ transplants; it will be like we are falling back to a “19th century environment,” she said.
She said a global action plan is needed to fill a drug “discovery void” by researching and developing new medicines to treat emerging, mutating infections. Antibiotics are failing and new bacterial diseases are on the rise, Davies noted. While hospitals have been able to get somewhat of a handle on MRSA and C difficile, there is an alarming increase in other bacteria including new dangerous strains of E coli and Klebsiella, which causes pneumonia.
These “gram negative” bacteria, which are found in the gut rather than on the skin, are highly dangerous to older people and those with weakened immune systems. Few antibiotics are effective in treating these strains and that number grows smaller all the time. Davies noted that nearly 5,000 people die each year in the UK due to gram negative sepsis, mainly because the bacteria is resistant to antibiotics.
Davies said pharmaceutical companies need to be encouraged to develop new antibiotic drugs. Currently, many pharms do not view antibiotic manufacturing as a profitable business, which could have dire implications if necessity cannot find a way to override those views.
"We haven't had a new class of antibiotics since the late 80s and there are very few antibiotics in the pipeline of the big pharmaceutical companies that develop and make drugs," she said, noting that the Innovative Medicines Initiative — an EU-funded body whose aim is to promote the development of new medicines — should be taken more seriously by drug makers.
But even as alarming as an increase in antibiotic-resistant bacteria has become, it is even more alarming that new cases of total drug resistant tuberculosis and a new wave of “super superbugs,” ones with a mutation called NDM 1, are starting to show up all over the world.
The WHO also states that 150,000 deaths per year are due to multi-drug resistant tuberculosis
“We haven't as a society globally incentivized making antibiotics. It's quite simple - if they make something to treat high blood pressure or diabetes and it works, we will use it on our patients everyday. Whereas antibiotics will only be used for a week or two when they're needed, and then they have a limited life span because of resistance developing anyway,” said the WHO in a statement.
As far as MRSA (methicillin-resistant Staphylococcus aureus) is concerned, there has been an 85 percent reduction in the number of cases throughout the world, thanks in part to increased awareness. At most, large hospital networks now only see a few cases of MRSA per year.
However, for every case of MRSA, there exists 50 to 100 cases of gram-negative bacterial infection, according to Professor Mike Sharland of St. George´s Hospital in London.
"This is your own gut bugs turning on you,” he expressed. “Between 10 percent and 20 percent are resistant to drugs. We do not yet know why they are on the rise, although some hospital procedures, such as the use of catheters, may be implicated. Many are in the very young or older population.”
Davies said the government needs to treat the new wave of superbugs as seriously as they treated MRSA when that was a major health threat. She said for a measure to work, all areas of the government need to be on board, including the Dept. of Environment and Food and Rural Affairs.
Davies said there needs to exist ways to incentivize the pharmaceutical industry to invest in finding and developing new antibiotics. Most companies have given up the hunt because despite their long-winded efforts, resistance continues to develop.
The EU´s Dept. of Health said it would publish a five-year action plan to tackle the health crisis raised in Davies´ report, which will include measures to ensure the drugs are prescribed only when needed.
The report, which lists 17 recommendations on tackling the superbug crisis, has received applause from experts in the field. However, one expert says the UK does not have the resources to fight this war on its own.
Richard James, former director of the center for healthcare at the University of Nottingham, said that global action is vital, especially in areas where antibiotics are over-used, wrongly used and in some countries — particularly southern Europe — can be bought over-the-counter.
"Anyone reading the report will realize that there are no magic bullets," he told The Guardian´s Sarah Boseley. "The majority of the 17 recommendations relate to actions in the UK alone but there is acknowledgment of the requirement for the UK government to campaign for this issue to be given higher priority internationally."
James suggested that the government should explore the use of a tax on antibiotic use and also enlist a measure to encourage the development of alternatives (vaccines, etc.) by small biotechnology companies and universities.
Laura Piddock, professor of microbiology at Birmingham University and director of Antibiotic Action, said Davies was taking the right track drawing political attention to the antibiotic discovery void.
“However, there are an increasing number of infections for which there are virtually no therapeutic options, and we desperately need new discovery, research and development; the UK is extremely well-placed to do basic discovery and research for new antibacterial molecules,” said Piddock.
The Association of the British Pharmaceutical Industry (ABPI) also applauded Davies´ report.
"Antimicrobial resistance is a serious and growing problem," said ABPI chief executive Stephen Whitehead. "There are, however, pharmaceutical companies actively involved in researching and developing new antimicrobial medicines. But more still needs to be done and we believe that for there to be a continual supply of effective antibiotics, a comprehensive review of the R&D [research and development] environment and good stewardship are required urgently."
Nigel Brown, president of the Society for General Microbiology, agreed Davies´ was right to call for an urgent action plan. He said members of his group would work harder to better understand infectious diseases, reduce transmission of antibiotic resistance and help develop new antibiotics.
"The techniques of microbiology and new developments such as synthetic biology will be crucial in achieving this," he told Reuters´ Kate Kelland.
Davies is not the first chief medical officer in the UK to draw attention to the antibiotic crisis.
In 2008, her predecessor, Liam Donaldson, urged doctors not to use antibiotics to treat colds because they are caused by viruses and do not respond to antibiotics. And in 1999, Sir Kenneth Calman made a similar plea, saying the public had a responsibility not to demand antibiotics.