The World Health Organization (WHO) is warning of a “silent pandemic” of antimicrobial resistance from infections caused by deadly pathogens that doctors cannot cure due to a lack of new drugs.
According to an early release of special presentations by Dr. Valeria Gigante and Professor Venkatasubramanian Ramasubramanian from an online “pre-meeting” of the European Congress of Clinical Microbiology & Infectious Diseases on April 15-18 in Copenhagen, Denmark.
“Antibiotic resistance is one of the major concerns in modern medicine today,” Dr. Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau Hospital on Long Island, New York, told Fox News Digital.
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“There is a shortage of safe, effective and inexpensive means to treat many of these significant infections,” Glatt added.
“It is critical that new and innovative products are explored.”
According to a new release, there are about five million deaths each year from antimicrobial resistance. (iStock)
According to the release, there are approximately five million deaths from antimicrobial resistance each year.
Treatment of drug-resistant infections involves newer agents that are more expensive than standard therapies, so poor people are disproportionately affected by antimicrobial resistance, the release said.
“More than 2.8 million antimicrobial-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result,” the Centers for Disease Control and Prevention (CDC) noted on its website, according to 2019 data.
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“When Clostridioides difficile — a bacteria that is not typically resistant but can cause deadly diarrhea and is associated with antibiotic use — is added to this, the U.S. toll from all threats in the report exceeds 3 million infections and 48,000 deaths.”
Resistant germs, such as bacteria and fungi, develop resistance to antibiotics and antifungals when they are allowed to grow, even though the drug tries to kill them.
“It doesn’t mean our bodies are resistant to antibiotics or antifungal drugs,” the CDC said on its website.
What new drugs are being studied?
A 2021 WHO review found that there are about 27 antibiotics under investigation against pathogens that the WHO designed as “critical” – such as two bacteria known as Acinetobacter baumannii and Pseudomonas aeruginosa.
The WHO considers only a small subset of the antibiotics currently under development in clinical trials to be “innovative” enough to overcome resistance.
“Pseudomonas and Acinetobacter are always the two bacteria most commonly listed, although there are certainly more resistant forms of candida (fungal) infections that you could add to the list,” Dr. Cameron Wolfe, an infectious disease specialist at Duke University Hospital in Durham, North Carolina, told Fox News Digital.
There is also an “increasing number of environmental bacteria with really significant resistance – [such as] recent extensive drug resistance Shigella, and ongoing municipal water outbreaks of Mycobacterium abscess,” he said.
In this 2013 archival photo, a microbiologist works with tubes of bacterial samples in an antimicrobial resistance and characterization lab within the Centers for Disease Control and Prevention’s (CDC) Infectious Disease Laboratory in Atlanta, Georgia. (The associated press)
But the WHO considers only a small subset of the antibiotics currently under development in clinical trials to be “innovative” enough to overcome resistance.
“In the five years covered by this report, we have approved only 12 antibiotics, of which only one – Cefiderocol – is able to tackle all pathogens considered critical by the WHO,” says Gigante, team leader of the WHO Antimicrobial Resistance Unit in Geneva. , Switzerland, in the 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 drug resistance mechanism growing 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 causes the bacteria to become “resistant” by breaking down the “last line of defense” of a class of antibiotics that treats a broad spectrum of different bacteria known as carbapenems — which are often prescribed when other antibiotics have failed, according to the issue. .
Most strains that acquire this gene are resistant to all commonly used antibiotics, making them a “superbug,” according to multiple reports.
“Ideally, you only need an antibiotic for a short period of time, but a cholesterol drug or an HIV antiviral is forever,” said one doctor. (iStock)
Escherichia coli and Klebsiella pneumoniae are the most common bacteria to make this gene, “but the gene for NDM-1 can spread from one strain of bacteria to another,” according to the release.
Why isn’t more research being done?
“You ideally only need an antibiotic for a short period of time, but a cholesterol drug or an HIV antiviral is forever,” Wolfe noted.
Pharmaceutical companies need to invest in the research and development phase to find an antimicrobial agent that can fight drug-resistant pathogens, experts say.
“Look at how many different statin drugs we have that are essentially identical.”
But these drugs are just as likely to fail in this process as drugs for other diseases that can provide a much better return on investment, such as cancer and heart drugs.
“The problem is a combination of scientific difficulty (these are complex drug resistance mechanisms that must be overcome, often mechanistically requiring very different drugs), regulatory complexity (FDA approval path is long and extremely costly, and the approval path is in every country is different), and economics (it’s often just cheaper to bring ‘me-too’ drugs to market than trying to completely redesign a new drug),’ Wolfe told Fox News Digital in an email. .
Excessive and improper use of antimicrobial agents leads to resistance. (iStock)
“Look at how many different statin drugs we have that are essentially identical,” he added.
He continued, “How many SSRIs [selective serotonin reuptake inhibitor] depression drugs are available with minimal differences compared to the previous ones? Still, companies can make a stronger bet in that area, because high cholesterol or depression won’t turn against you.”
The last new class of antibiotics to be discovered was in the 1980s, with the first antibiotic from this class, daptomycin, coming to market in 2003, according to the release.
Why does resistance arise?
Excessive and improper use of antimicrobial agents leads to resistance. The CDC estimates that approximately 47 million antibiotic prescriptions in doctor’s clinics and emergency departments — an estimated 28% of all prescriptions in these settings — are prescribed in the U.S. each year for infections that don’t require antibiotics, such as the common cold and flu.
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There is also a global trend for pathogens to develop resistance to antimicrobials much faster after they are introduced.
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, per release.
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“Although the United States has much less resistance to gram-negative infections, compared to low- and middle-income countries (LMIC), it’s only a matter of time before global travel and bacterial ingenuity catch up,” said Ramasubramanian, president of the Clinical Infectious Diseases Society of India and Consultant Infectious Diseases & Tropical Medicine, Apollo Hospitals, based in Chennai, India, told Fox News Digital.