The World Health Organization (WHO) recently released its first list of the world's most dangerous “superbugs” – raising the alarm about 12 families of bacteria that have developed resistance to even the most powerful antibiotics, and according to the report, making hospital, nursing home stays and routine surgeries more dangerous.
Infectious disease experts have long feared the emergence of bacteria that cannot be treated with available drugs. It’s a scene where a surgeon or family doctor watches helplessly as an infection progresses without having the tools to help keep their patient alive.
According to the U.S. Centers for Disease Control and Prevention, at least 2 million Americans become infected with bacteria that are resistant to antibiotics each year, and at least 23,000 die as a direct result.
The Infectious Disease Society of America warns that “microbes continue to become more resistant, the antibiotic pipeline continues to diminish, and the majority of the public remains unaware of this critical situation.”
Moreover, we’re seeing the proliferation of drug resistant microbes worldwide. In fact, the United Nations now identifies antimicrobial resistance as a global health crisis, placing its severity on par with AIDS and Ebola by convening a high level General Assembly meeting late last year to address the issue.
The WHO has cautioned that regional and/or isolated interventions will have limited impact, in part because of the truly global danger posed by a broad range of deadly bacteria that have become resistant to treatment and the ease with which international travel can help them spread.
The threat currently extends to many types of bacterial infection:
- The three most pernicious antibiotic resistant bacteria in the world — Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae) have developed resistance to even the newest antibiotics.
- Multidrug resistant tuberculosis is on the rise around the world.
- Malaria—for which the drug artemisinin was a major breakthrough in treatment (celebrated with a Lasker Award in 2011), is demonstrating resistance to even this powerful drug.
- And some viruses, including HIV can develop resistance to treatment.
We do know some ways to stem the problem. Good infection control practices – from hand washing at home to isolation procedures in hospitals are simple but critical.
Antibiotics should only be used when truly needed.
Routine ‘colds,’ caused by viruses, should not be treated with antibiotics. For those bacterial infections for which antibiotics are appropriately indicated, the full course of medication should be taken as prescribed.
Further, the selling of over-the-counter antibiotics in many parts of the world contributes to their inappropriate use and the emergence of resistance. And the widespread use of antibiotics in animal agriculture has clearly been implicated in the development of resistant bacteria that can spread to humans. Such practices should be reviewed and challenged.
But more efforts are needed, on multiple fronts, and immediately. The number of new antimicrobial agents in development has slowed and the antibiotic pipeline is insufficient.
Investigators must embrace the importance of this field of research; policymakers must ensure that regulations do not discourage R&D; and pharmaceutical companies must invest in their development.
We must prioritize research to develop new drugs; to identify new ways to prevent, diagnose, and treat infection; and to clarify the best ways to use the antimicrobial tools available to us.
Microbes evolve resistance quickly and it is unrealistic to believe that even fast-tracked research and development, as essential as it is, will create enough new therapies quickly enough to “beat the bugs.”
That’s why we must also explore new ways to combat infection – from behavioral interventions that can decrease spread of disease, to strengthening healthcare infrastructure so infections are treated quickly before they can extend to others.
We must identify non-drug approaches as well, such as the use of UV light in in appropriate areas of hospitals to directly kill bacteria. And we must research better approaches to using the drugs we have on hand, for example using shorter courses of antibiotics where research shows it to be safe and effective.
We must join our voices to make this public health threat a policy and research priority and impress upon our elected representatives and policymakers at home and abroad the importance of funding for biomedical research.
Only if we act together as part of a concerted research and public health effort can we hope to find effective treatments against the deadly threat of the superbugs.
Claire Pomeroy, M.D., M.B.A., is president of the Albert and Mary Lasker Foundation, dedicated to advancing medical research.