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Updated: January 25, 2013 04:55 IST

Antibiotic resistance’s ‘apocalyptic’ threat

Ian Sample
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The issue of drug resistance is as old as antibiotics themselves, and arises when drugs knock out susceptible infections, leaving hardier, resilient strains behind. File photo: R. Ragu
The Hindu The issue of drug resistance is as old as antibiotics themselves, and arises when drugs knock out susceptible infections, leaving hardier, resilient strains behind. File photo: R. Ragu

British government strategy to promote more responsible use of antibiotics among doctors

Britain’s most senior medical adviser has warned MPs that the rise in drug-resistant diseases could trigger a national emergency comparable to a catastrophic terrorist attack, pandemic flu or major coastal flooding.

Dame Sally Davies, the chief medical officer, said the threat from infections that are resistant to frontline antibiotics was so serious that the issue should be added to the government’s National Risk Register of Civil Emergencies.

She described what she called an “apocalyptic scenario” where people going for simple operations in 20 years’ time die of routine infections “because we have run out of antibiotics.”

The register was established in 2008 to advise the public and businesses on national emergencies that Britain could face in the next five years. The highest priority risks on the latest register include a deadly flu outbreak, catastrophic terrorist attacks, and major flooding on the scale of 1953, the last occasion on which a national emergency was declared in the U.K.

Speaking to MPs on the Commons science and technology committee, Davies said she would ask the Cabinet Office to add antibiotic resistance to the National Risk Register in the light of an annual report on infectious disease she will publish in March.

Davies declined to elaborate on the report, but said its publication would coincide with a government strategy to promote more responsible use of antibiotics among doctors and the clinical professions. “We need to get our act together in this country,” she told the committee.

The issue of drug resistance is as old as antibiotics themselves, and arises when drugs knock out susceptible infections, leaving hardier, resilient strains behind. The survivors then multiply, and over time can become unstoppable with frontline medicines. Some of the best known are so-called hospital superbugs such as MRSA.

“In the past, most people haven’t worried because we’ve always had new antibiotics to turn to,” said Alan Johnson, consultant clinical scientist at the Health Protection Agency (HPA). “What has changed is that the development pipeline is running dry. We don’t have new antibiotics that we can rely on in the immediate future or in the longer term.” Changes in modern medicine have exacerbated the problem by making patients more susceptible to infections. For example, cancer treatments weaken the immune system, and the use of catheters increases the chances of bugs entering the bloodstream.

“We are becoming increasingly reliant on antibiotics in a whole range of areas of medicine. If we don’t have new antibiotics to deal with the problems of resistance we see, we are going to be in serious trouble,” Johnson added. The supply of new antibiotics has dried up for several reasons, but a major one is that drugs companies see greater profits in medicines that treat chronic conditions, such as heart disease, which patients must take for years or even decades. “There is a broken market model for making new antibiotics,” Davies told the MPs.

She has met senior officials at the World Health Organisation and her counterparts in other countries to develop a strategy to tackle antibiotic resistance globally.

Powerful drugs losing efficacy

Drug resistance is emerging in diseases across the board. Davies said 80 per cent of gonorrhea was now resistant to the frontline antibiotic tetracycline, and infections were rising in young and middle-aged people. Multi-drug resistant TB was also a major threat, she said.

Another worrying trend is the rise in infections that are resistant to powerful antibiotics called carbapenems, which doctors rely on to tackle the most serious infections. Resistant bugs carry a gene variant that allows them to destroy the drug. What concerns some scientists is that the gene variant can spread freely between different kinds of bacteria, said Johnson.

Bacteria resistant to carbapenems were first detected in the U.K. in 2003, when three cases were reported. The numbers remained low until 2007, but have since leapt to 333 in 2010, with 217 cases in the first six months of 2011, according to the latest figures from the HPA. — © Guardian Newspapers Limited, 2013

@Ingrid...thanks for the info, it would be helpful for us(Indians) if
you can elaborate more about the bug you were talking about

from:  sumanth
Posted on: Jan 25, 2013 at 18:33 IST

Ingrid could you tell me how many people have died of this new and terrible drug resistant microbe and whether it is the first detected carbapenem resistant bacteria , whether it is the most common carbapenem resistant bacteria and whether it is treatable by other antibiotics and so on and that will be a complete discussion.

from:  Ram
Posted on: Jan 25, 2013 at 14:27 IST

The world has been made aware recently of a v virulent and totally resistant new bacteria that has emerged in India. An Indian doc released this info as he thought it was so dangerous he should let the world know but he has been totally ostracised in India for 'bringing shame on India'. This is silly misplaced patriotism.It could happen in many countries. I should imagine v few Indians know of it or believe it. This germ is nothing short of horrific.It turns gd germs into itself, like a science fiction horror. What it does to a humans organs is terrifying and NOTHING will stop its course. Only amputation is the only hope if a limb is infected, as to vital organs, there isnt any hope. Three people in this country came back from india with it and were immediately isolated and amputations conducted.They became infected through an accident throwing them into roadside gutters. I think Indians are not being informed much abt it.

from:  Ingrid
Posted on: Jan 25, 2013 at 10:37 IST
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