How worried should we be about the antibiotic apocalypse?

While the news in 2016 was filled with obituaries of beloved world icons, looking back, there may have been one passing of particular importance: that of an elderly woman in Washoe County, US.

Why, you may ask? The answer is short, but the implications are potentially massive: the woman was the first known carrier of a superbug that is resistant to all 26 FDA approved antibiotics. As a result, historians may look back on 2016 as the year the antibiotic apocalypse began.

Warnings of the impending threat of antimicrobial resistance are nothing new. As far back as 1945, in an interview after being awarded the Nobel Prize for the discovery of antibiotics, Alexander Fleming warned of the dangers of overusing antibiotics. This case shows antibiotic resistance may no longer be just a threat, but instead a reality.

Despite the talk of apocalypse, hope is not lost. Just last year the UN and the World Health Organisation took the first major steps in dealing with antimicrobial resistance.

They agreed to create a task force, with the aim of helping governments around the world prevent infection and develop new treatment initiatives.

Thankfully, infection of superbugs remains uncommon, and normal hygiene practices are enough to save most of us.

Many people already carry superbugs, as you read this you may have MRSA living on your skin. Do not panic though, unless someone’s immune system is not functioning properly, they are unlikely to get infected.

For hospital patients the story is slightly different, where other illnesses or treatment have left them with a compromised immune system, they are vulnerable to infection by otherwise benign superbugs. Hospital staff rely on strong levels of hygiene to limit the spread of superbugs before they can infect the patients, and gain more resistances.

Bacteriophages may offer a potential salvation when the strongest antibiotics fail. Bacteriophages are viruses that infect specific bacteria, hijacking the internal machinery of the bacteria to do their bidding and weaken the bacteria.

Recent human trials of bacteriophages have shown some promise as an alternative to antibiotics, with a study last year proving them to be effective against bacteria, similar to the kind found in Washoe County, Klebsiella pneumoniae.

The only downside is that we first need to know the specific strain any infection belongs to, otherwise the bacteriophage will have no effect. Back in the US, the origin of the superbug was traced back to India. The patient had recently spent a large amount of time there, requiring hospitalisation for a femur fracture and subsequent bone infections which are likely to be when infection occurred.

Superbugs in the region are more common than in western countries, likely due to the over prescription of antibiotics in the region, along with lower hygiene standards within some of the hospitals.

Despite the reality of growing resistance, this case remains an isolated incident. At least for now.

 

Image: Martin Cathrae

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