We're losing the battle against antibiotic resistant bugs, says WHO
The World Health Organization (WHO) has issued its first report dealing with the threat of antibiotic resistance around the world, and the news is not good.
The invention of antibiotics has been an incredible boon for human civilization, allowing us to treat illnesses and diseases that have caused widespread death in the past. However, a growing problem has been the threat of antibiotic resistance. As these medications kill off the bugs in our system that are making us sick, they don't always kill them all. Those bugs that survive exposure to the antibiotics can develop a resistance to them, and pass on that resistance to their descendants. Since new generations of these microbes can be produced in mere hours, this can quickly develop into a situation where the bugs are always one step ahead of our medical professionals.
The spread of this resistance has often been a concern for the future, but this new report from WHO is saying that the threat is here, now, and it's only going to get worse.
"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," said Dr. Keiji Fukuda, WHO’s Assistant Director-General for Health Security, in a press release. "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."
Their are several reasons for the spread of this resistance. Some of it is natural, due to microbes transferring genes between themselves. Over-use of antibiotics is certainly one, sometimes due to being prescribed in error, and other times since they are demanded by the patient, even though they won't be effective (like people insisting on them when dealing with a virus, like the cold or the flu). Other times the antibiotics are prescribed properly, and they are effective against whatever bugs are affecting the patient, but the patient does not complete the full course of treatment, because they feel better. When it comes down to it, any exposure to antibiotics that doesn't kill a microbe has the chance of producing resistance in that microbe.
According to the report, in the 1980s, when antibiotics were first used to treat urinary infections caused by E. coli, resistance to these antibiotics was non-existent. Today, it is widespread. Methicillin-resistant Staphylococcus aureus (MRSA) is a concern in hospitals these days, with those infected estimated at being over 60 per cent more likely to die than if they were infected with a non-resistant strain. A major worry expressed by the report is regarding the spread of resistance to so-called 'last resort' medications - antibiotics that are effectively the last line of defence against some life-threatening bugs. For example, in some parts of the world, resistance to carbapenems, a class of antibiotics used as a last resort to treat serious hospital-related infections due to a bacteria known as Klebsiella pneumoniae, only work in roughly half of patients being treated. Also, resistance to last-resort treatments for gonorrhoea have shown up in nearly a dozen countries around the world, including Canada.
There are ways to slow down the spread of resistance, and perhaps delay the onset of this 'post-antibiotic era.' The recommendations given by WHO include using antibiotics only when necessary and prescribed by a doctor, finishing the full course of treatment, more care in prescribing antibiotics, and better monitoring and tracking of resistance.
The full World Health Organization report, titled Antimicrobial resistance: global report on surveillance 2014, is available online here.
Although not dealt with in this report, equally worrisome these days are outbreaks of several illnesses, including measles and whooping cough, that are mainly attributed to the number of parents who have chosen not to have their children vaccinated against them. This trend stemmed from a now-retracted study published in the late 1990s, which proposed a link between the MMR (measles, mumps, and rubella) vaccine and autism. It took over 10 years, but repeated studies proved that the paper was wrong, and its wildly-speculative conclusions had no basis in fact. Of the original 12 co-authors of the study, 10 issued a retraction, and the journal that originally published the study removed it from the journal database. Despite this retraction, the wide-spread misinformation continues to impact the reputation of vaccines and many parents still refuse to participate in vaccination efforts.