On Monday, the World Health Organization published a list of the world’s twelve top-priority pathogens, all of which have high resistance to antibiotics and pose an imminent threat to human health (1). The list is the first of its kind, and is intended to give government officials a consolidated look at which pathogen-induced diseases are most in need of publicly funded research. Without the incentive of government funding, health officials fear that pharmaceutical companies will continue to allocate the majority of their research funds to the production of profitable, rather than necessary, drugs. As long as effective treatments are not being developed, the public continues to be at significant risk, especially the very young, the very old, those with compromised immune systems, and those with limited access to health care and education.
The published list is divided into three priority categories: medium, high, and critical (1). While all pathogens on the list are resistant to most common antibiotics, those in the ‘critical’ category are also resistant to carbapenem, the strongest and most effective available antibiotic (1). Infection by these pathogens is untreatable, and leads to almost certain death or serious illness for those who contract it. Other pathogens on the list are responsible for diseases such as staph infection, stomach ulcers, and gonorrhea. Controversially, the list does not include tuberculosis. The reason, as stated on the WHO web page, is that research for its treatment is already being “targeted by other, dedicated [programs]” (1). Strains of the streptococcus bacteria and chlamydia are also not included due to “low levels of resistance to existing treatments and [not currently posing] a significant public health threat” (1).
At the root of the ‘superbug’ crisis is the rise of antibiotic overexposure. When bacteria are exposed to antibiotics that are not strong enough to kill them, they become immune to that antibiotic and become a more resistant form of bacteria. As the more resistant forms of bacteria multiply and continue to be exposed to antibiotics, the bacteria eventually becomes resistant to even some of the strongest antibiotics, making infection difficult or impossible to treat (2). Weak antibiotics are commonly included in meat, food products and cleaning products, and are often over prescribed for treating minor infections. There has also been evidence to show that antibacterial hand soaps may contribute to the superbugs’ increased prevalence in our environment (3). The most harmful superbugs however, are most commonly found in hospitals, especially long-term acute care hospitals, where 1 in 4 infections are caused by antibiotic-resistant bacteria (4). In total, at least 2 million Americans contract antibiotic-resistant bacterial infections every year, and 23,000 of those infections result in death (5). With the G20 summit in Germany occurring in July, many hope that world leaders will take the WHO’s list into consideration, and take action against superbugs before their full impact is realized.
References:
(1) “WHO publishes list of bacteria for which new antibiotics are urgently needed.” WHO, 27 Feb. 2017, http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/en/
(2) “Antibiotic resistance.” BBC, http://www.bbc.co.uk/schools/gcsebitesize/science/21c/keeping_healthy/antibiotics_drug_testingrev4.shtml
(3) “FDA issues final rule on safety and effectiveness of antibacterial soaps.” FDA, 2 Sep. 2016, https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm517478.htm
(4) “Superbugs threaten hospital patients.” CDC, 3 Mar. 2016, https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm517478.htm
(5) “Antibiotic/Antimicrobial Resistance.” CDC, https://www.cdc.gov/drugresistance/
(6)Image Source: Creative Commons (https://www.flickr.com/photos/niaid/16598492368)