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Is the “superbug apocalypse” upon us? This question has bothered infectious-disease physicians for years.
While some believe that the antimicrobial resistance crisis has begun, others say it is on the verge of breaking out.
The fact remains that hundreds of thousands of people worldwide are already dying from antimicrobial resistance or superbugs that plague healthcare institutions.
Antimicrobial resistance is a condition where microorganisms such as bacteria, viruses, fungi and parasites do not respond to drugs that were originally effective to treat the infections they caused.
When the microorganisms become resistant to most antimicrobials, they are often referred to as “superbugs”.
Patients diagnosed with superbugs are generally at increased risk of negative clinical outcomes or death. However, there is a glimmer of hope.
The World Health Organisation (WHO) announced this week that it had partnered with the Drugs for Neglected Diseases initiative, with the aim of developing new antibiotic treatments to address the public health threat of antimicrobial resistance.
The two bodies will focus on research and development under the Global Antibiotic Research and Development (Gard) banner.
A final report by the Review on Antimicrobial Resistance, a two-year project commissioned by UK Prime Minister David Cameron, was released on May 18. It revealed that antimicrobial resistance would kill 10 million people by 2050.
About 4.15 million of those deaths would occur in Africa, including South Africa, which has had its share of people – albeit minimal – diagnosed with antimicrobial resistance.
And a recent study by researchers from the National Institute for Communicable Diseases (NICD) and Wits University found that antimicrobial resistance was a key public health concern that threatened the effective treatment of severe infections.
The authors, led by epidemiologist Olga Perovic from the institute, noted that “efforts need to be intensified in the fight against the resistance” to minimise the danger it posed.
Dr Marie-Paule Kieny, WHO assistant director-general, said: “We need more investment in research and development for new antibiotic treatments, or we could lose the cornerstone of modern medicine – and infections and minor injuries that have been treatable, may once again kill.
“But we also need to change the way we are using new antibiotics to slow down resistance building. Gard will endeavour to build in conservation aspects in the research and development process, while ensuring that any new products coming out of this initiative will be affordable for all.”
Locally, to arrest the spread of antimicrobial resistance, the NICD is conducting surveillance to determine the number of cases reported from various hospitals, by month, for selected pathogens (bacteria, virus and fungi) – and to describe antimicrobial susceptibility to the most important treatment regimens, by pathogen and by hospital.
Data taken from 14 major hospitals in Gauteng, KwaZulu-Natal, Free State and Western Cape showed that South Africa needed to be on high alert as the pathogens and parasites causing common opportunistic infections such as meningitis, urinary tract infection and pneumonia were resistant to drugs used to treat them.
Acinetobacter baumannii, which causes pneumonia, was found to be resistant to most drugs tested on it – with the resistance rate as high as 75% in some cases. Klebsiella pneumoniae, which has killed 13 people – including newborns – at various Johannesburg hospitals, was resistant to many antimicrobials, including last-generation antibiotics like Ciprofloxacin and Piperacillin-tazobactam.
