The World Health Organization (WHO) is warning of a “silent pandemic” in antimicrobial resistance, caused by infections caused by deadly pathogens that doctors are unable to cure due to a lack of new agents.
This is stated in the early publication of Dr. Valeria Gigante and Professor Venkatasubramanian Ramasubramanian’s special presentations from the “preliminary meeting” of the European Congress of Clinical Microbiology and Infectious Diseases 15-18. April in Copenhagen, Denmark.
“Antibiotic resistance is one of the biggest concerns in modern medicine,” Dr. Aaron Glatt, director of infectious diseases at Mount Sinai South Nassau Hospital in Long Island, New York, told Fox News Digital.
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“There is a shortage of safe, effective and affordable drugs that can be used to treat many of these significant infections,” Glatt added.
“It is important that new and innovative products are researched.”
According to a new release, approximately five million people die each year due to antimicrobial resistance. (iStock)
According to the release, approximately five million deaths are related to antimicrobial resistance each year.
Newer substances are used to treat drug-resistant infections, which are more expensive than standard treatments, so microbial resistance disproportionately affects poor people, the release states.
“More than 2.8 million antimicrobial-resistant infections occur in the United States each year, and more than 35,000 people die as a result,” the Centers for Disease Control and Prevention (CDC) stated on its website, according to 2019 data.
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“When you add in Clostridioides difficile — a bacterium that is not typically resistant but can cause fatal diarrhea and is associated with antibiotic use — the total number of reported threats in the U.S. exceeds 3 million infections and 48,000 deaths.”
Resistant bacteria, such as bacteria and fungi, develop resistance to antibiotics and antifungals when they are able to grow even when the medicine tries to kill them.
“It does not mean that our bodies are resistant to antibiotics or antifungals,” the CDC said on its website.
What new drugs are being studied?
A 2021 review by the WHO revealed that there are about 27 antibiotics in research trials against pathogens designated by the WHO as “critical”, including two bacteria known as Acinetobacter baumannii and Pseudomonas aeruginosa.
WHO considers only a small subset of antibiotics currently in development in clinical trials to be sufficiently “innovative” to overcome resistance.
“Pseudomonas and Acinetobacter are always the two most commonly listed bacteria, although there are certainly more drug-resistant forms of candida (yeast) infections that you can add to the list,” Dr. Cameron Wolfe, an infectious disease specialist at Duke University Hospital in Durham, North Carolina, told Fox For News Digital.
There are also “increasing amounts of environmental bacteria that have really significant resistance – [such as] recent widespread drug-resistant Shigella and ongoing municipal waterborne outbreaks of Mycobacterium abscessus,” he said.
In this 2013 file photo, a microbiologist works with bacterial sample tubes in the Antimicrobial Resistance and Characterization Laboratory at the Centers for Disease Control and Prevention (CDC) Infectious Diseases Laboratory in Atlanta, Georgia. (Associated Press)
But the WHO considers only a small subset of antibiotics currently in clinical trials to be “innovative” enough to overcome resistance.
“In the five years covered by this report, we have only had 12 antibiotics approved, of which only one – Cefiderocol – has been able to target all pathogens considered critical by WHO,” said Gigante, of the WHO’s Division of Antimicrobial Resistance in Geneva. , Switzerland, in a press release.
Most strains that acquire this gene are resistant to all commonly used antibiotics, making them a “superbug.”
Experts are particularly concerned about one mechanism of drug resistance that is increasing among bacteria worldwide. Certain bacteria can acquire a gene that produces an enzyme known as New Delhi metallo-beta-lactamase 1 (NDM-1).
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This gene allows bacteria to become “resistant” by breaking down the “last line of defense” of a class of antibiotics that treat a wide range of different bacteria known as carbapenems – which are often prescribed when other antibiotics have failed. release.
Most strains that have acquired this gene are resistant to all commonly used antibiotics, making them a “superbug” according to several reports.
“You ideally only need an antibiotic for a short time, but a cholesterol drug or an HIV drug is forever,” said one doctor. (iStock)
Escherichia coli and Klebsiella pneumoniae are the most common bacteria that produce this gene, “but the NDM-1 gene can spread from one bacterial strain to another,” according to the release.
Why not do more research?
“You ideally only need an antibiotic for a short time, but a cholesterol drug or an HIV drug is forever,” Wolfe noted.
Drug companies need to invest in the research and development phase to find an antimicrobial agent that fights drug-resistant pathogens, experts say.
“Look at how many different statin drugs we have that are basically identical.”
Yet these drugs are just as likely to fail in this process as drugs for other diseases that may have a much better return on investment, such as cancer and heart drugs.
“The problem is a mix of scientific difficulties (these are complex drug resistance mechanisms to overcome, often requiring mechanistically very different drugs), regulatory complexities (the FDA approval path is long and very expensive, and the approval path is different in every country), and economics ( it’s often simply cheaper to bring me-too drugs to market than to try to design an entirely new drug), Wolfe told Fox News Digital in an email.
The overuse and misuse of antimicrobials creates resistance. (iStock)
“Look at how many different statin drugs we have that are basically identical,” he added.
He continued, “How many SSRIs [selective serotonin reuptake inhibitor] are antidepressants available with small differences compared to the previous ones? Still, companies can make a stronger bet in this area because high cholesterol or depression won’t backfire on you.”
The last new class of antibiotics was discovered in the 1980s, when the first antibiotic from this class, daptomycin, hit the market in 2003, according to the publication.
Why does resistance develop?
The overuse and misuse of antimicrobials creates resistance. The CDC estimates that approximately 47 million antibiotic prescriptions are made in physician clinics and emergency departments each year in the United States—an estimated 28% of all infections prescribed in these settings—for infections that do not require antibiotics, such as colds and flu.
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There is also a global trend for pathogens to develop resistance to antimicrobials much faster after their introduction.
Between 1930 and 1950, the average time to develop resistance was 11 years – but this dropped to just two to three years between 1970 and 2000, according to the publication.
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“Although the United States has far less resistance to gram-negative infections compared to low- and middle-income countries (LMICs), it’s only a matter of time before global travel and bacterial ingenuity catch up,” said Ramasubramanian, president of Clinical Infectious. Diseases Society of India and Consultant Infectious Diseases & Tropical Medicine, Apollo Hospitals, located in Chennai, India, told Fox News Digital.