Antibiotics are losing their power to fight infections in every country in the world, according to new data from the World Health Organisation — a situation that could have “devastating” consequences for public health. It raises the possibility that once-beaten diseases will re-emerge as global killers.
Antibiotic resistance is a major threat to public health, says the WHO. It is no longer something to worry about in the future, but is happening now and could affect anybody, anywhere, of whatever age.
Dr Keiji Fukuda from WHO says: “Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public-health goods and the implications will be devastating.”
The new report is the first to gather comprehensive data from the WHO on antibiotic resistance and has information from 114 countries. Although the data is more complete in some regions than in others, it is clear that drug-resistant strains of bacteria and viruses are common and that trying to preserve the efficacy of the antibiotics we have is a losing battle.
Most troubling is that the data collected by the WHO shows there is resistance all over the world to the “last resort” antibiotics used against life-threatening infections that are caused by a common intestinal bacterium, Klebsiella pneumoniae.
This bacterium is a major cause of infections acquired by some very vulnerable patients in hospital. It can cause pneumonia, bloodstream infections and infections in newborns and intensive-care unit patients. The antibiotics of last resort are the carbapenems — but the report says there is resistance to them in every region. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.
Very serious cases of bacteria resistant to carbapenems have been caused by an enzyme called NDM1. “That is a particularly vicious one,” said Dr Danilo Lo Fo Wong, senior adviser on antimicrobial resistance to WHO Europe. There have been no new classes of antibiotics for 25 years, said a WHO official.
“New antibiotics coming on to the market are not really new,” he said. “They are variations of those we already have.” That means that bacteria are likely to develop resistance to them that much sooner.
The report also highlights widespread resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E coli. In the 1980s, when the fluoroquinolones were introduced, there was virtually no resistance, but now in many countries, they are ineffective in more than half of patients.
The WHO urges all countries to be more sparing in their use of antibiotics in humans and in animals and improve hand hygiene, which has been credited with reducing the numbers of cases of the “superbug” MRSA — Staphylococcus aureus, which is resistant to the antibiotic methicillin — in the UK.
Prof Martin Adams, president of the Society for Applied Microbiology, also called for more research into how resistance develops in human and animal antibiotic use. “Even if there are new antimicrobial drugs brought to market, we will still face the spectre of resistance unless we can learn how to minimise or slow its development,” he said.
— © Guardian Newspapers Limited, 2014
