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Posted at 08:00 AM ET, 03/15/2013

This is what we need to fight the ‘super-bugs’


A lab technician holds a bacteria culture that shows a positive infection of enterohemorrhagic E. coli, also known as the EHEC bacteria, from a patient at the University Medical Center Hamburg-Eppendorf on June 2, 2011 in Hamburg, Germany. (Sean Gallup - GETTY IMAGES)

They almost sound like apocalyptic scenarios out of a Hollywood disaster flick a la "Contagion" . You scrape your knee in a scooter accident and are suddenly fighting for your life in a hospital due to an infection that can’t be stopped. You check into a hospital for a routine operation, and within days, you are dead. These deadly “super-bugs” suddenly develop resistance to all known antibiotics, causing widespread pandemics of the kind that existed centuries ago.

The first scenario comes from the World Health Organization, which recently studied the link between the threat posed by “super-bugs” (bacteria resistant to all forms of antibiotics) and our failure to develop new types of antibiotics over the past two decades. The second scenario comes from Britain’s Chief Medical Officer, Dame Sally Davies, who warned on Monday of a global health catastrophe on the scale of global warming or terrorism if we don’t soon find a source of new antibiotics. The third scenario comes from the Centers for Disease Control (CDC), which warned last week that the U.S. faced a "nightmare bacteria" threat on a scale never before seen.

In other words, we have a real problem on our hands if we don’t do something quickly to address the seemingly inexplicable rise of these super-bugs that are able to spread quickly from host to host, develop resistance to all known antibiotics, and pack a lethal punch (50 percent fatality rate). These so-called "Triple Threat" bacteria could soon make any infection unstoppable and turn back the clock on our efforts to use antibiotics to neutralize the bacteria responsible for anthrax, TB and typhoid fever.


After 24 hours, this inoculated MacConkey agar culture plate cultivated colonial growth of Gram-negative, small rod-shaped and facultatively anaerobic Klebsiella pneumoniae bacteria. (Courtesy CDC)
The long-term solution — provided you’re willing to wait a generation or so for societal behaviors to change - is for us to stop taking antibiotics like they’re candy. If you have the common cold, in other words, don’t ask your doctor for antibiotics. The more antibiotics we use, the more resistant the bacteria become, and the more likely that they spread this antimicrobial resistance to a wider community of super-bugs. (It doesn’t help that our nation’s livestock munches away on antibiotics, either.)

A more immediate solution is to turn to the innovators at the big pharmaceutical companies or smaller biotech companies to churn out new classes of antibiotics the bacteria haven’t seen before. If they haven’t seen the antibiotics before, they can’t have developed a resistance to them. That’s easier said than done, for one simple reason: most pharmaceutical companies no longer want to develop antibiotics because they can’t make any money doing so. As The Guardian’s science correspondent Ian Sample suggests, they prefer to develop drugs for chronic illnesses that patients will take for every day of their lives, rather than an antibiotic that’s wildly expensive to develop and only used for a week or two by any patient. As a result, only a handful of large pharmaceutical companies are still in the antibiotics game, and even these companies are not developing new antibiotics at a fast enough rate.

If we’re really serious about avoiding a catastrophic health scenario, such as the scary outbreak of Klebsiella pneumoniae two years ago, then we need to provide incentives for innovation in the antibiotics pipeline, such as subsidies or tax credits for antibiotics research and development. We need to develop innovative new approaches to dealing with these triple-threat bacteria that take into account our new knowledge of the human genome. And we can support movements such as the 10 x '20 Initiative, which is a global effort by public health organizations and medical practitioners to develop 10 new antibiotics by the year 2020. Otherwise, any of us could become an unfortunate character in a real-life “Contagion” — Patient Zero in an epidemic outbreak with unknown origins and potentially deadly consequences for everyone.

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