For only the fourth time in the United Nations’ 70-year history, the organization hosted a special meeting on a health issue. Last week, world leaders gathered in New York for a high-level meeting about the growing threat from antimicrobial resistance and superbugs.
In May of this year, a drug-resistant strain of E. coli bacteria was found for the first time in the United States. It was discovered when a 49-year-old Pennsylvania woman sought treatment at a local clinic for a urinary tract infection. Samples of the bacteria were sent to Walter Reed National Military Medical Center for testing. It was confirmed that the E. coli carried a resistance gene known as Mcr-1.Â
The same bacteria has been found in China and parts of Europe.Â
Tom Frieden, director of the Centers for Disease Control (CDC), expressed concern about the infection, saying it shows that we’re close to the “end of the road for antibiotics.”
Dr. Margaret Chan, director general of the World Health Organization (WHO), spoke at the meeting in New York.Â
“Antimicrobial resistance is a global crisis — a slow motion tsunami,” she said. “The situation is bad and getting worse.”Â
WHO revised its guidelines for sexually transmitted diseases (STDs), which may become untreatable.Â
“The misuse of antimicrobials, including their underuse and overuse, is causing these fragile medicines to fail, outpacing the world’s capacity for antibiotic discovery,” Chan said.
Over the past half-century, only two new classes of antibiotics have reached the market. With few replacement products in the pipeline, the world is heading toward a post-antibiotic era in which common infections, especially those caused by gram-negative bacteria, will kill as they once did.
Last year, the World Health Assembly approved a global action plan for combating antimicrobial resistance. What we must see now is action. The pharmaceutical industry is reluctant to invest in costly antibacterial discovery because the return on investment is considered poor.
When compared with drugs that are taken by patients for their lifetimes, such as those that treat high blood pressure, high cholesterol, allergies and the like, antibiotics are prescribed for only a short time. Drug companies say they target certain diseases but can fail after a brief market life.
Consumers must stop demanding antibiotics when they have a viral infection, such as a cold or flu. Also, better diagnostic tests are needed so that antibiotics are prescribed only on the basis of a firm diagnosis. And more vaccines are needed to prevent infections.
It was also brought up at the meeting that the food industry needs to reduce its massive use of antibiotics, at sub-therapeutic doses, to promote growth and alleviate illness caused by overcrowding. Worldwide, two-thirds of all antibiotics are fed to animals.
Specific antibiotics listed by WHO as critically important for human medicine should not be used in animal husbandry or agriculture. One of these classes of drugs is Colistin, which is often used to treat difficult gram-negative infections. Its significance is that the genetic mechanism that confers resistance to Colistin is harbored on a plasmid — a sort of circular form of DNA that resides outside the main DNA of the organism.
It is believed that if this Colistin-resistant bundle of genes were to get into another strain of bacteria, or another species, then we could potentially have a “superbug,” described Dr. Barun Mathema, professor of epidemiology at Columbia University’s Mailman School of Public Health, in an interview on NPR with “Here and Now’s” Meghna Chakrabarti.Â
“There are already pathogens that are resistant to everything but Colistin,” Mathema said.
While the pharmaceutical companies are dithering about whether to invest in research on new antibiotics, researcher Andreas Peschel has authored a German study that discovered a promising candidate among the bacteria growing inside human noses.
Mouth or gut microbes feast on a constant flow of food, while nasal bacteria dwell in a kind of wasteland, and as a result they have developed potent weapons to compete for scant nourishment and ensure their survival.
The German researchers found a bacterium, Staphylococcus lugdunensis, that produces a chemical compound, possibly a powerful antibiotic against resistant bacterial strains that threaten to kill 10 million people a year by 2050. Tests in mice have shown that lugdunin is effective against a range of potentially deadly infections, including MRSA, which is acquired in hospitals and sickens 90,000 Americans annually.
Pharmacists have been warning for years about antibiotic resistance and many HMOs and doctor’s offices now sport posters warning patients not to ask for antibiotics. It is heartening to see a world organization attack this looming threat.