The World Health Organization released what is a essentially a ‘most wanted list’ of the 12 families of bacteria that pose the greatest threat to our health. WHO officials hope that this list we will spur research and development of new antibiotics. Many of the bacteria listed are already resistant to multiple antibiotics.
“Antibiotic resistance is growing, and we are fast running out of treatment options,” Marie-Paule Kieny, WHO’s assistant director-general for health systems and innovation, said in a statement. “If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”
Antibiotics are one of the most important discoveries in human history. Before the development of penicillin at the turn of the 20th century, an infection in even a small cut could be fatal. Life expectancy in the U.S. increased at its fastest rate after the discovery of penicillin.
We could see a return to the days of fatal bacterial infections as more bacteria develop resistance to drugs. The problem is spreading across the world. In some countries, the medicines that treat urinary tract infections caused by E. coli–fluoroquinolones are ineffective in more than half of patients.
The WHO issued its first global report on antibiotic resistance in 2014. Keiji Fukuda, WHO’s assistant director-general for health security, warned in a statement: “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill.
“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”
Today’s list amplifies and focuses the concerns. Antibiotic needs are divided into three categories: critical, high and medium. The WHO worked with researchers at the Division of Infectious Diseases at the University of Tübingen, Germany, to compile the list. They evaluated bacteria based on level of drug resistance, ease of transmission and health threat to determine which make the list.
Scientists and health workers welcomed the list for bringing attention to the problem and calling on governments to prioritize antibiotic research and development.
“This report marks a major step forward in identifying which bacteria pose the greatest risk for patient care because of a lack of effective treatment,” said Evelina Tacconelli, executive committee member of the European Society of Clinical Microbiology and Infectious Diseases, in a statement. “We hope that it will drive governments and research groups working in antibiotic development to set the right research priorities that will reduce the burden of antibiotic-resistant infections globally.”
Doctors Without Borders (MSF) also applauded the report adding that government support for research and development should ensure that the drugs that are produced are affordable. MSF also pointed out that drugs alone are not going to help deal with growing resistance.
“Improved diagnostics – ones that are fast, easy to use in field settings, and that can determine what infections are bacterial, identify what bacteria they are, and assess whether they are resistant to certain drugs – are crucial to reducing inappropriate antibiotic use in the first place,” according to the MSF statement. “Better infection prevention and control measures, strengthened microbiology laboratory services and surveillance, increasing the use of suitable vaccines and better education of health professionals and patients on rational antibiotic use are among the best tools we have to prevent further development of resistant infections and avoid the unnecessary use of the precious antibiotics we currently have.”
The three critical bacteria often infect people in hospitals and older people causing pneumonia and severe blood infections. They are all resistant to most available antibiotics, including the most advanced multi-drug forms.
The remaining nine bacteria on the list also show resistance to antibiotics but pose a less significant health threat. They cause things like ear infections, gonorrhea and food poisoning. Tuberculosis was left off the list because the WHO already issues separate reports warning of emerging drug resistance.
The complete list:
Priority 1: Critical
1. Acinetobacter baumannii, carbapenem-resistant
2. Pseudomonas aeruginosa, carbapenem-resistant
3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: High
4. Enterococcus faecium, vancomycin-resistant
5. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
6. Helicobacter pylori, clarithromycin-resistant
7. Campylobacter spp., fluoroquinolone-resistant
8. Salmonellae, fluoroquinolone-resistant
9. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: Medium
10. Streptococcus pneumoniae, penicillin-non-susceptible
11. Haemophilus influenzae, ampicillin-resistant
12. Shigella spp., fluoroquinolone-resistant