The World Health Organization (WHO) warns of a “silent pandemic” of antimicrobial resistance from infections caused by deadly pathogens that doctors can’t cure for lack of novel agents.
This comes from 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 and Infectious Diseases from 15 to 18 April in Copenhagen, Denmark.
“Antibiotic resistance is one of the major concerns of modern medicine today,” said 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 lack of safe, effective, and inexpensive ways to treat many of these significant infections,” added Glatt.
“It is critical that new and innovative products are explored.”
According to the press release, antimicrobial resistance is responsible for about five million deaths each year.
Treatment for drug-resistant infections involves newer agents that are more expensive than standard therapies, leaving poor people disproportionately affected by antimicrobial resistance, the press release said.
“More than 2.8 million antimicrobial-resistant infections occur in the United States each year, and more than 35,000 people die as a result,” the Centers for Disease Control and Prevention (CDC) noted, according to 2019 data on its website.
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“When Clostridioides difficile – a bacterium that is not normally resistant but can cause fatal diarrhea and has been linked to antibiotic use – is added, the US toll of 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 if they are allowed to grow even though the drug is trying to kill them.
“This does not mean that 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 about 27 antibiotics are in research studies against pathogens classified by the WHO as “critical” – such as two bacteria known as Acinetobacter baumannii and Pseudomonas aeruginosa.
The WHO considers only a small subset of the antibiotics currently being developed in clinical trials to be “innovative” enough to overcome resistance.
“Pseudomonas and Acinetobacter are always the two bacteria that get listed most often, although there are certainly more drug-resistant forms of Candida (yeast) infections that you could add to the list,” said 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 large-scale Shigella resistance to drugs and ongoing outbreaks of Mycobacterium abscesses in municipal water,” he said.
But the WHO considers only a small subset of the antibiotics currently being developed in clinical trials to be “innovative” enough to overcome resistance.
“In the five years covered by this report, we had only 12 approved antibiotics, of which only one – cefiderocol – was able to attack all pathogens considered critical by the WHO,” said Gigante, team leader at WHO -Antimicrobial Resistance Unit in Geneva, Switzerland, in the press release.
Most strains that acquire this gene are resistant to all common antibiotics, making them a “superbug”.
Experts are particularly concerned about a drug resistance mechanism that is increasing in 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 allows bacteria to become “resistant” by breaking through the “last line of defense” of a class of antibiotics that treat a wide spectrum of different bacteria known as carbapenems – which are often prescribed when other antibiotics have failed release.
Most strains that acquire this gene are resistant to all common antibiotics, making them a “superbug,” according to multiple reports.
Escherichia coli and Klebsiella pneumoniae are the most common bacteria that make this gene, “but the gene for NDM-1 can spread from one strain of bacteria to another,” the press release said.
Why isn’t more research done?
“Ideally, you only need an antibiotic for a short time at a time, but a cholesterol drug or an HIV antiviral drug is forever,” Wolfe noted.
Pharmaceutical companies need to invest in the research and development phase to find an antimicrobial agent that fights drug-resistant pathogens, experts say.
“Look at how many different statins we have that are basically the same.”
Yet these drugs are just as likely to fail during this process as drugs for other diseases that can yield a much better return, such as cancer and heart drugs.
“The problem is a mixture of scientific difficulties (these are complex drug resistance mechanisms to overcome and which mechanistically often require very different drugs), regulatory complexity (FDA approval path is long and extremely costly, and the approval path is different in each country ), and economics (it’s often just cheaper to market ‘me-too’ drugs than trying to completely redesign a new drug),” Wolfe told Fox News Digital in an email.
“Look at how many different statin drugs we have that are basically the same,” he added.
He continued, “How many SSRIs [selective serotonin reuptake inhibitor] Depression drugs are available with minimal differences compared to the predecessor? Still, companies in this space may have a stronger bet since high cholesterol or depression won’t work against you.
The last newly discovered class of antibiotics was discovered in the 1980s, with the first antibiotic in this class, daptomycin, hitting the market, according to the 2003 publication.
Why does resistance develop?
Overuse and improper use of antimicrobials lead to resistance. The CDC estimates that approximately 47 million antibiotic prescriptions in physician’s offices and emergency rooms — an estimated 28% of all prescribed in those facilities — are prescribed annually in the United States for infections that don’t require antibiotics, such as the common cold and flu.
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There is also a global trend that pathogens 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, the publication says.
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“Although the United States has far less resistance to gram-negative infection compared to low- and middle-income countries (LMICs), it’s a matter of time before global travel and bacterial ingenuity catch up,” Ramasubramanian, president of Clinical Infectious Diseases Society of India and Consultant in Infectious Diseases and Tropical Medicine, Apollo Hospitals, based in Chennai, India, told Fox News Digital.