Here’s a fact: Bacteria are getting tougher! Hence, no truly novel antibiotics have made it to market in over three decades. The World Health Organization (WHO) has issued a list of the top dozen bacteria most dangerous to humans. According to the U.S. Centers for Disease Control and Prevention, at least 23,000 people die each year in the U.S. from infections caused by resistant bacteria.
In a press briefing on Monday, February 27, the U.N. health agency warns that doctors are fast running out of treatment options. It likewise issued a list that is intended to promote the development of medicines for the most worrying drug-resistant bacteria, including salmonella and Staphylococcus aureus. It also urged the medical experts and health care practitioners to come up with new drugs that can address these urgent concerns and eliminate risks to mankind.
“The list is not meant to scare people about new superbugs, but to signal to researchers and pharmaceutical companies what their priorities should be,” said Marie-Paule Kieny, the WHO’s assistant director-general for health systems and innovation.e. The crucial drugs are unlikely to be big moneymakers for companies that develop them, she note. So governments and health agencies need to cooperate to boost the chances that they will be developed in time.
Meanwhile, WHO said that the most-needed drugs are for germs that threaten hospitals, nursing homes and among patients who need ventilators or catheters. The agency said the dozen listed resistant bacteria are increasingly untreatable and can cause fatal infections. These – most typically – strike people with weakened immune systems.
The second and third categories on the priority list include increasingly drug-resistant bacteria that cause more common diseases such as sexually transmitted gonorrhea and foodborne illness caused by salmonella.
Doctors, researchers, and health officials have been sounding the alarm for years about the rise of antibiotic resistance. The list, developed by researchers at the University of Tübingen in Germany, took into account the level of resistance each class of pathogen has already acquired, how deadly it can be, how widespread, and the burden it causes to health systems.
A study in The Lancet warns superbugs are already causing many post-surgical infections which are making routine surgery more dangerous. There are predictions that without effective antibiotics, much of modern health care would be in jeopardy, including cancer chemotherapy, births by cesarean section, and organ transplantation.
At the top of the said list, in a black box labeled “critical,” are three of the most fearsome resistant bacteria in the world: Acinetobacter baumannii, Pseudomonas aeruginosin, and Enterobacteriaceae.
This trio of bugs thrives in hospitals and residential care facilities, infecting patients already weak and dependent on ventilators and catheters. They can cause potentially deadly blood and respiratory infections and are resistant to even the most powerful antibiotics.
These species are all examples of what’s called gram-negative bacteria. These are “superbugs” that usually live in the gut that has developed two cellular membranes, which make it harder for drugs to penetrate the double exterior membranes. They may also have developed an ingenious system to protect themselves against any molecule that might kill them.
“So if you can’t get the molecule in, it can’t act and kill the bacteria,” said Carolyn Shore, head of the antibiotic innovations group at Pew Charitable Trusts. The US-based non-profit is working with scientists and the industry as a whole to develop new antibiotics.
There are about 40 new antibiotics in clinical development, but only about one in five new drugs has been successfully approved for human use. Of the drugs the pipeline now, only a fraction would be effective against Gram negative bugs. “The pipeline remains thin,” Shore said.
“Because there wasn’t a huge return on investment and the high cost of [research and development]outweighs the revenue of any potential new product, a lot of the big companies got out of the space,” she added.
Researchers in Canada are working on new approaches to antibiotic therapy, including searching for novel methods to attack bacteria and ways to shut off acquired resistance genes so that old drugs are once again effective.
The WHO also warned that the new drugs by themselves won’t solve the antibiotic resistance problem. It’s also calling on health officials to develop ways to reduce the risk of infections and encourage the responsible use of existing drugs in both humans and animals.