Concerns about spreading microbial antibiotic resistance (termed antimicrobial resistance) are prompting new action by government organisations.
Infectious agents (notably bacteria) can rapidly acquire genetic elements that confer resistance to the mechanism of action of different antibiotic groups. In recent years there have been alarming rises in the rates of multi-drug resistant (MDR) infections, including some patients who develop infections from pathogens that are resistant to all known antibiotics.
Now the US Centers for Disease Control and Prevention (CDC) has begun categorising antibiotic-resistant pathogens by threat level. A new publication, Antibiotic resistance threats in the United States, 2013, states that there are more than two million antibiotic resistant infections and more than 20,000 related deaths annually. They have dubbed the pathogens as concerning, serious or urgent. This last, most dangerous category includes carbapenem-resistant Enterobacteriaceae (including E. Coli) and resistant forms of Clostridium Difficile and Neisseria gonorrhoeae.
The CDC has also announced a plan to tackle the problem of antibiotic resistance, including exhortations to the public, patients and families, and health professionals to observe good practice to minimise infections and the unnecessary use of antibiotics.
Meanwhile, the UK Department of Health recently announced a new Antimicrobial Resistance Strategy. Antimicrobial resistance has been added to the Government’s National Security Risk Assessment and a five-year plan to address the issue launched by Public Health Minister Anna Soubry.
This strategy includes measures to improve education and good practice to prevent and limit the spread of infection and ensure proper use of antibiotics; to improve data gathering and monitoring of drug resistance in infectious agents; and to stimulate the development of new and improved antibiotics, infectious disease diagnostics, and other treatments.
It also sets aside £4 million for a new National Institute of Health Research (NIHR) Health Protection Research Unit to study antimicrobial resistance and healthcare associated infections. Of note, genome sequencing can be used for rapid identification of specific pathogen species and strains, and to determine which genetic elements are present conferring different forms of antibiotic resistance.