New pandemic lurks due to resistant bacteria

The World Health Organization (WHO) draws attention to this during World Antibiotic Resistance Week from 18 to 24 November. Professor Constance Schultsz conducts research into antimicrobial resistance and emerging infectious diseases: “There are ICs outside the Netherlands where bacteria are even untreatable.”

An estimated 700,000 people worldwide – mainly children and the elderly – die each year from sepsis (blood poisoning), pneumonia and tuberculosis caused by bacteria that cannot be controlled by conventional antibiotics. The majority live in low- and middle-income countries. The United Nations predicts a significant increase in the number of deaths from infectious diseases against which antibiotics no longer work in the next three decades: to more than 10 million per year.

The Netherlands is still doing quite well

“Most people don’t see this or notice it,” says Constance Schultsz, who is affiliated with Amsterdam UMC and the Amsterdam Institute for Global Health & Development (AIGHD). With some bacteria, the situation is improving in certain European countries. Such as the infamous ‘hospital bacterium’ MRSA, which is resistant to common antibiotics and mainly occurs in places where many antibiotics are administered. “Hospitals have taken measures to keep MRSA at bay. But with other bacteria you see increasing resistance in Europe.”
The Netherlands is still doing quite well, says Schultsz. “Because we do infection prevention, we follow the rules for antibiotic use – such as not prescribing anything for a cold – and because we can only get antibiotics with a prescription. But here too doctors see, for example in people with urinary tract infections, that resistance is starting to become a problem. Intensive care units also have problems with bacteria that various antibiotics cannot control. There are ICs outside the Netherlands where bacteria are even untreatable.”

Poor insight into the scope of the problem

“We don’t know exactly how things are going in the rest of the world, especially in low- and middle-income countries,” the professor continues. “We don’t have a good idea of ​​the magnitude of the problem.” She is trying to change that with her research. “Why is the situation in those countries also relevant to us? You can take such a resistant bacteria home from your holiday address, just to name one example.” How easy that is, is shown by a 2017 study among healthy Dutch travelers. Nearly 90 percent of the people who visited India came back with a bacteria that produces an enzyme (ESBL) that breaks down antibiotics.

Detect resistance

Better data on resistance in poorer regions also contribute to the different use of antibiotics in these countries. If you know which medicines no longer help against a certain infection, you can prescribe more specifically. That is why the OASIS project was launched a few years ago. This is an initiative of the AIGHD and research institutions from France, Germany and the African countries of Togo and Burkina Faso. They developed a so-called ‘surveillance strategy’ that allows you to determine faster and more efficiently how often resistance occurs somewhere. Good results have been achieved with this in Indonesia. The method is currently being tested in Togo and Burkina Faso. Schultsz: “Together with the German ‘RIVM-for-animals’, we want to see whether we can measure resistance in animals more efficiently with this method. The WHO is now also interested.”
To reduce resistance worldwide, the AIGHD has entered into a public-private partnership: AMR Global, with Schultsz as chairman of the steering committee. AMR Global has an ambitious vision: everyone who needs it should have access to effective and affordable antibiotics.

Behavior of bacteria

Knowledge about their behavior is required in order to effectively combat pathogenic bacteria. How do they spread? Which genes of a bacterium ensure that it becomes resistant to a particular drug? Can this resistance easily transfer from animal to human and vice versa from human to animal? Schultsz investigated this in E. coli, a bacterium that occurs naturally in our intestines. This micro-organism has an unpleasant property, says the professor: “It is able to pass on its resistance to antibiotics to members of its own species that were not yet resistant.” Important information, although you can’t do much with it in practice yet. “In theory, you could develop drugs that switch off the genes involved. But we are not that far yet.”

New pandemic lurks due to resistant bacteria
Source link New pandemic lurks due to resistant bacteria

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