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1st May 2014

Antibiotic resistance – a major global threat

Antibiotic resistance is now a "major global threat" to public health, according to a report by the World Health Organisation (WHO).

 

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A new study by WHO – its first global report on antimicrobial resistance – reveals that this serious threat is no longer a prediction for the future, but is happening right now, in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance occurs when bacteria evolve so that antibiotics no longer work in people who need them to treat infections. Over the last 30 years, no major new types of antibiotics have been developed.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, Assistant Director-General for Health Security. “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.”

Key findings of the report

The report, "Antimicrobial resistance: global report on surveillance", notes that resistance is occurring across many different infectious agents, but it focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases. These include bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea. The results are grave cause for concern, documenting resistance to antibiotics – especially “last resort” antibiotics – in all regions of the world.

Key findings include:

  • Resistance to "last resort" treatment for life-threatening infections caused by a common intestinal bacteriaK. pneumoniae – has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections. In some countries, antibiotics no longer work in over half of people treated.

  • Resistance to a widely used medicine for treatment of urinary tract infections caused by E. coli is very widespread. In the 1980s, resistance was virtually zero. Today, there are countries around the world where drugs are now ineffective in more than half of patients.

  • "Last resort" treatment failure for gonorrhoea has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.

  • Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of healthcare with longer stays in hospital and more intensive care required.

Ways to fight antibiotic resistance

The report shows that basic systems to track and monitor the problem have gaps or do not exist in many countries. While some countries have taken important steps in dealing with antibiotic resistance, every country and individual needs to do more. Actions to prevent infections from happening in the first place include better hygiene, access to clean water, infection control in healthcare facilities, and vaccination. Individuals can help tackle resistance by taking antibiotics only when prescribed by a doctor; completing the full prescription, even if they feel better; and never sharing antibiotics with others or using leftover prescriptions.

The report is kick-starting a global effort led by WHO to address drug resistance. This will involve the development of new tools and standards and improved collaboration around the world to track resistance, measure its health and economic impacts, and design targeted solutions. The report also covers other infections such as HIV, malaria, tuberculosis and influenza. It provides the most comprehensive picture of drug resistance to date, incorporating data from 114 countries.

Despite the apparent doom and gloom in this report, some recent developments offer hope. Last year, for example, it was discovered that adding small amounts of silver can make antibiotics up to 1,000 times more effective. Researchers also made progress in identifying the molecular events that occur when antibiotics are ejected from a bacterial cell. Phage therapy is another possibility – and somewhat later down the line, the use of nano-robotics.

 

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