The problem is just getting worse. Antibiotic-resistant bacteria, viruses and microbes are responsible for nearly 700,000 deaths each year. Staph infections. C. difficile outbreaks in hospitals. Tuberculosis. Malaria. Sexually transmitted infections such as syphilis and gonorrhea.
Last month’s meeting of the United Nations (UN) General Assembly indicated a need to raise awareness of the issue – but the situation is already dire, according to Microbiology and Immunology professor David Heinrichs.
“How much worse does this have to get before people start paying attention? A lot of people don’t seem to be paying much attention to the severity of the issue,” he said, noting the topic was the impetus for a UN meeting late last month.
On Sept. 21, 193 nations signed a declaration to combat superbugs – drug-resistant bacteria and microbes that have adapted and become immune to antibiotics.
“This is the fourth time in the history of the UN they’ve talked or discussed health-related issues on a global scale. (The others were HIV, non-communicable diseases and Ebola.) This is a pretty important meeting. My hope is it brought a lot of attention to the issue,” said Heinrichs, whose lab focuses on methicillin-resistant staphylococcus aureus (MRSA), a drug-resistant superbug and one of the most notorious pathogens in the hospital environment.
“The organism I study kills more people in North America than HIV/AIDS does. And that’s just one organism,” he stressed. “You have clostridium difficile, lots of viruses that are resistant to antimicrobials, as well. We have all sorts of infectious diseases that are soon going to be without a method of controlling them.”
Speaking at the meeting, UN Secretary-General Ban Ki-moon said antimicrobial resistance poses “a fundamental, long-term threat to human health, sustainable food production and development.”
He continued, “It is not that it may happen in the future. It is a very present reality – in all parts of the world, in developing and developed countries; in rural and urban areas; in hospitals; on farms and in communities.”
The UN hoped to bring attention to this problem. Antibiotics are overused on a global scale for practices that have nothing to do with treatment of infectious disease.
For example, in farming, they’re used for making animals bigger, increasing productivity of meat supply. Runoff from the overuse of antibiotics in the sewer system is worth mentioning, too. It’s contaminating the environment, while antibiotics are generally overprescribed. Microorganisms evolve and with repeated exposure to antibiotics, they’ve adapted and become immune.
Generally speaking, we’ve contributed to the problem – that is the prevailing opinion, Heinrichs said.
For the first time, heads of state committed to taking a broad, coordinated approach to address the root causes of antimicrobial resistance across multiple sectors, especially human health, animal health and agriculture. Seen as a collective effort to address a challenge to health, food security and development, countries reaffirmed their commitment to develop national action plans on antimicrobial resistance, based on the Global Action Plan on Antimicrobial Resistance – the blueprint for tackling antimicrobial resistance, developed in 2015 by the World Health Organization (WHO), in coordination with Food and Agriculture Organization of the United Nations and World Organization for Animal Health.
In a joint statement issued during the meeting, the three organizations said, “such plans are needed to understand the full scale of the problem and stop the misuse of antimicrobial medicines in human health, animal health and agriculture.”
Leaders recognized the need for stronger systems to monitor drug-resistant infections and the volume of antimicrobials used in humans, animals and crops, as well as increased international cooperation and funding. The statement also highlighted some of the commitments made by world leaders in tackling antimicrobial resistance, including strengthening regulation of antimicrobials, improving knowledge and awareness, promoting best practices, as well as fostering innovative approaches to using alternatives to antimicrobials and new technologies for diagnosis and vaccines.
“Antimicrobial resistance poses a fundamental threat to human health, development and security. The commitments made today must now be translated into swift, effective, lifesaving actions across the human, animal and environmental health sectors. We are running out of time,” said Dr. Margaret Chan, BA’73, MD’77, DSc’99, Director-General of WHO.
“It’s about raising awareness with physicians, farming practices, making the public simply more aware of the issue. Scientists have been aware of this for some time, but we typically do a very poor job of making things more known to the public,” Heinrichs added.
“Academic scientists and pharmaceutical companies are always investing resources into the development of new antimicrobials. It’s a constant evolution of trying to find new drugs to combat resistance that is evolving in bacteria. It’s a very difficult thing to do.”
Some of the new things being tested in the fight against drug-resistant bacteria and microbes are combinatorial drugs, or adjuvant therapy – something added to make something else work better, Heinrichs explained. Adjuvant therapy uses certain molecules in combination with traditional antibiotics in an effort to make them more effective again.
“We put adjuvants in vaccines to make them work better. With this, it is adding molecules to an antibiotic to which bacteria have become resistant, so there’s a research area that looks to see if we can re-sensitize bacteria to old antibiotics by using combinations of drugs together,” he said.
MRSA is one of the most notorious pathogens in hospital environments and the spread of community acquired MRSA is now becoming prevalent. His lab is looking to identify new targets – new genes that encode proteins which could be a target for a new drug inhibitor.
“We’re basically at the ground level, working to find new ways where new antibiotics will be effective,” he explained.