Tracking the global threat of antibiotic resistance

WASHINGTON, D.C.; April 12, 2011

The discovery stems from a recent study, involving a new bacterial transport vehicle, called a plasmid, which is a way for bacteria to transfer antibiotic resistance genes to each other.

The scientific community has been aware of plasmids for some time now, however, this new one is different.

The new plasmid, called IncP-1, was found to have the ability to transfer antibiotic resistance between completely different species of bacteria.Also, harmless bacteria which normally live in humans were found to have the ability to develop resistance genes and transfer them via the plasmid vehicle to harmful bacteria which cause infections.

This could be one reason for the increasing rates of antibiotic resistant bacteria occurring now.

The surge of antibiotic resistant bacteria and the lack of new antibiotics to fight them had the World Health Organization so concerned that they made this issue the focus of World Health Day 2011.

The Infectious Diseases Society of America (IDSA) rolled out a multi-faceted plan just last week in an effort to combat these deadly bacteria.

The IDSA warned that unless its recommendations are implemented now, the future could look more like the past, before the days of antibiotics, when people were regularly dying of common infections.

The incidence of antibiotic-resistant bacteria, including MRSA and the recently spreading carbapenem-resistant klebsiella pneumonia (CRPK), has skyrocketed over the past two decades. Every year these infections kill nearly 100,000 US hospital patients. These infections are also on the rise in community settings, affecting healthy people.

Just MRSA alone kills more Americans every year than homicide, HIV/AIDS, Parkinson's disease, and emphysema combined. These infections are also a financial strain, with an annual cost to the US health care system of up to $34 billion and over 8 million additional hospital days.

The rise of antibiotic resistant bacteria is partly due to overuse of antibiotics and the rapid rate at which bacteria are able to develop resistance.

Only two new antibiotics have been approved by the Food and Drug Administration (FDA) since 2008. The decline of antibiotic research and development (R&D) by pharmaceutical companies is hailed as one of the problems.

In 1990, there were 20 pharmaceutical companies with active R&D programs. Today, there are only two. Drug companies have shifted their focus to the development of more lucrative drugs that treat chronic conditions, such as diabetes and high blood pressure.

The IDSA policy paper summarizes recommendations about how to best address the dual crises of antibiotic resistance and lack of new antibiotics.

The recommendations include creating incentives for antibiotic R&D, so that pharmaceutical companies might once again view antibiotics as a lucrative endeavor. IDSA's goal is to have 10 new antibiotics by 2020, termed the 10 x 20 initiative.

Coordinated educational interventions are also recommended, to prevent inappropriate antibiotic use and limit antibiotic exposure. Educational programs will be expanded to target both physicians and patients.

The IDSA also encourages the development of research strategies that target antibiotic resistant bacteria, in order to better understand this problem with hopes of developing effective prevention and treatment strategies.

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