Untreatable infections pandemic fears grow
*Taking commonly prescribed class of antibiotics may double chances of heart failure
*Fish supper may carry risk of drug-resistant disease-causing organisms, research finds
Nineteen new forms of lethal superbugs have been found in the United Kingdom (UK), a major report revealed.
Officials said germs, which attack the blood; kidneys and bowels had evolved ways to breach the last line of antibiotic defences – threatening a pandemic of untreatable infections.
Public Health England, which today announces a five-year strategy to address the ‘urgent threats’ of infectious diseases, said it had discovered 19 ‘new genetic mechanisms of antibiotic resistance’ in its labs in ten years.
The superbugs, found in 1,300 different ‘antibiotics of last resort’ such as carbapenems and colistin could not treat samples taken from patients, meant infections.
The bacteria, which include new forms of the Multi Resistant Staphylococcus Aureus (MRSA), gonorrhoea and enterococcus bugs, cause urinary tract infections, sexually transmitted diseases, kidney problems and bowel disease.
In each case, doctors were able to use experimental unlicensed drugs, a combination of old medicines or high doses to save lives.
But speaking at the annual Public Health Conference in Warwick, infectious diseases expert, Dr. Susan Hopkins, of Imperial College London, warned: “The doomsday scenario is that we can’t treat patients.”
She said health authorities are desperately trying to avoid a ‘tipping point’ in which drugs stop working against common infections.
She added that in some southern European countries, such as Italy and Greece – where antibiotic resistance is a bigger problem – doctors could no longer carry out bone marrow transplants in case a patient gets an untreatable infection. Hopkins told doctors at the conference that they all needed to take responsibility for reducing unnecessary use of antibiotics, which is driving the problem.
“There’s no point in pointing the finger over there [at other medical professionals] – we are all personally responsible and professionally responsible and we all need to take action together.”
Professor Alastair Hay, a General Practitioner (GP) and professor of primary care at the University of Bristol, said the UK was in the top quarter of nations in Europe for reducing antibiotic prescriptions but lagged behind the best countries, such as Germany and the Netherlands, where prescribing rates were around a third lower.
Meanwhile Professor Chris Whitty, who will become the Government’s chief medical officer next month, said: “Despite our arsenal of vaccines and antimicrobials, infectious disease remains a real threat to public health.
“We are constantly faced with new threats, and antimicrobial resistance is growing. This new strategy will enable us to detect and prevent new threats as they arise.”
PHE’s new infectious diseases report, which sets out the strategy to address urgent health threats from 2020 to 2025, also reveals that 12 new diseases were detected in England for the first time in the past decade.
These include pandemic ‘swine flu’, Middle East respiratory syndrome, Crimean-Congo haemorrhagic fever and monkeypox.
Meanwhile, a study suggests taking a common class of antibiotics may more than double your chances of getting a serious heart condition.
Researchers found patients using fluoroquinolones had a greater risk of developing aortic and mitral regurgitation, which can lead to heart failure.
The drugs are commonly used to treat everything from chest infections to urinary tract bugs. Ciprofloxacin is the most prescribed of these, but other types include levofloxacin, moxifloxacin and norfloxacin.
Researchers at the University of British Columbia (UBC) looked at 125,020 patients who’d taken antibiotics in the last year.
Some had been prescribed fluoroquinolones while others had taken amoxicillin or azithromycin – other types of antibiotics.
The research team discovered 12,505 cases of a leaky valve, which can affect how blood flows around the body.
They found current fluoroquinolone users were 2.4 times more likely to develop the condition than those on amoxicillin.
Meanwhile, patients on fluoroquinolone were at a 1.8 times greater risk than those using azithromycin.
Lead author, Dr. Mahyar Etminan, suggested that fluoroquinolones were being over-prescribed due to convenience.
The associate professor of ophthalmology and visual sciences at UBC said: “You can send patients home with a once-a-day pill.
“This class of antibiotics is very convenient, but for the majority of cases, especially community-related infections, they’re not really needed.
“The inappropriate prescribing may cause both antibiotic resistance as well as serious heart problems.”
The researchers hope their study helps inform the public and physicians that if patients present with cardiac issues, where no other cause has been discovered, fluoroquinolone antibiotics could potentially be a cause.
The findings were published in the Journal of the American College of Cardiology.
Figures suggest more than 675,000 fluoroquinolones were dispensed by GPs and other practitioners in England alone, and about the same amount again in hospitals.
But there have been claims the drugs – considered to be safe – can have side effects, such as tendon rupture, joint problems and nerve pain.
It is thought that because fluoroquinolones act on the mitochondria – powerhouses in cells responsible for releasing energy – effects can be felt all over the body, sometimes permanently.
Meanwhile, a plate of fish and chips is increasingly likely to expose people to untreatable bacteria because of the spread of superbugs at sea, new research has found.
Study of dolphins revealed a surge in antibiotic-resistant bugs that are dangerous to humans in the marine environment in just a handful of years.
While the mammals themselves are eaten in very few parts of the world, they are considered a good indicator for the safety of sea life that does end up as food.
Investigators at Florida Atlantic University periodically captured, swabbed then released Bottlenose dolphins from 2003 to 2015 in the Indian River Lagoon on the United States (US) Atlantic Coast.
They found that between 2009 and 2015 resistance to common antibiotics in various strains of E. coli more than doubled.
Meanwhile the resistance to drugs of a pathogen called Vibrio alginolyticus, known to cause serious seafood poisoning, also showed a significant increase.
Scientists also found evidence of resistant Acinetobacter baumannii, which is traditionally the cause of serious hospital-acquired infections.
Published in the journal Aquatic Mammals, the findings raise the prospect that diners of raw or undercooked fish could fall ill with bugs for which there are no useful medicines.
It comes days after Public Health England (PHE) revealed there have been 19 new drug-resistant types of bacteria discovered in the United Kingdom (UK) over the past 10 years.
Antimicrobial resistance (AMR) is one of the gravest public health emergencies facing the world, threatening to make common infections deadly for the first time in almost a century.
AMR occurs when the DNA of bacteria mutates, or where different types of bacteria acquire DNA off each other, rendering antibiotics ineffective.
It has been driven by profligate use of antibiotics in both human and animal health and by the fact that no new classes of the drugs have been developed in decades.
PHE estimates that roughly 5,000 people die due to the problem in Britain each year.
Adam Schaefer, who led the new research, said: “We have been tracking changes over time and have found a significant increase in antibiotic resistance in isolates from these animals.
“This trend mirrors reports from human health care settings. Based on our findings, it is likely that these isolates from dolphins originated from a source where antibiotics are regularly used, potentially entering the marine environment through human activities or discharges from terrestrial sources.”
Over 13 years the Florida team collected samples containing 733 pathogen isolates from 171 different Bottlenose dolphins. Eighty-eight per cent of these isolates were resistant to at least one antibiotic.
The most common resistance – found in 91.6 per cent – was to erythromycin.
Dr. Peter McCarthy, co-author, described the drug resistance found in the Indian River Lagoon, which is good model marine environments comparably close to dense human habitation, as a “significant public health concern.
“The nationwide human health impact of the pathogen Acinetobacter baumannii is of substantial concern as it is a significant nosocomial [originating in hospital] pathogen with increasing infection rates over the past 10 years.” he said.
“In addition to nosocomial infections, resistant strains associated with fish and fish farming have been reported globally.”
Global health chiefs are currently warning that increasing numbers of tuberculosis strains are becoming resistant to antibiotics.