Understanding the Apocalypse

MacKenzie, D. (2013). THE BACTERIAL APOCALYPSE. New Scientist, 217(2908), 6-7.

1. Antibiotic resistance poses an apocalyptic threat to human health

1. we are facing “nightmare bacteria” and losing the war against them (words of public health officials in the UK and the US)

2. McKenzie points out that the predicament is even worse than these words suggest

1. antibiotic resistant bacteria are out of control in some areas

2. new drugs exist but are stuck in the final stages of development due to regulatory hurdles

1. antibiotic resistance has been emerging for some time

1. antibiotic resistant tuberculosis

2. superbugs such as methicillin-resistant Staphylococcus aureus (MRSA).

3. New super strains of E. coli as well (usually they respond to antibiotics called carbapenems: antibiotics that have the broadest antibacterial properties of any drug known)

1. However, carbapenem-resistant Enterobacteriaceae (CRE) are now on the rise

1. CDC reports that 4 per cent of all Enterobacteriaceae infections in the US are now carbapenem-resistant.

1. Worryingly, this represents a fourfold increase over the past decade

2. Cases of CRE infection in the UK have soared from 17 in 2008 to 799 last year (2013)

1. In Greece, 68 per cent of Klebsiella (enterobacteria often causing respiratory and other infections) infections tested in 2011 were carbapenem-resistant.

1. Greece has the highest rate of antibiotic use in the European Union

2. the more antibiotics are used, the more resistant bacteria have an evolutionary advantage.

3. CRE may also be spreading to Greece from Asia, where antibiotics are largely uncontrolled

1. We need new drugs to defeat these bacteria; nothing is imminent

1. partly because existing antibiotics already attack the most obvious bacterial weak points

2. eight major companies have abandoned antibiotics since 1990; only three still develop them…isn't much money in it

3. catch-22: we lack enough people with similar CRE infections who are eligible for clinical trials.

4. even if development resumes, likely 10 to 15 years with no drugs to treat many of these infections

1. Important: Campaigners want US farmers to divulge how much antibiotic they are using in livestock, but a bid to enforce this failed in the US last week.

1. (from About.com) Unfortunately, if a bacterium gets a resistance gene stuck into its chromosomal DNA or picks one…all of its progeny will inherit the gene and the resistance it confers. …It's basically just Darwin's idea of the survival of the fittest, reduced to a microscopic level -- bacteria with these genes survive and outgrow susceptible variants. And our own less than judicious use of antibiotics actually selects for these resistant types!