tech2 News StaffMar 02, 2017 12:33:59 IST
The World Health Organisation (WHO) has published a list of 12 bacterial families that are the most dangerous to human beings. The list is divided into three categories based on the threat posed, critical, high and medium. The bacteria in the most critical section are multi drug resistant strains that pose a particular threat in hospitals and nursing homes, especially among patients that require the use of medical devices such as catheters and ventilators. The bacteria in the critical section can cause deadly infections including bloodstream infections and pneumonia.
The bacteria have abilities to find new ways to resist treatments, and can pass on the genetic material that allow other bacteria to be drug resistant as well. The bacteria in the most critical list are resistant to the best available treatments for multi-drug resistant bacteria, carbapenems and third generation cephalosporins. These bacteria are resistant to multiple antibiotics and are of immediate medical concern.
Dr Marie-Paule Kieny, WHO's Assistant Director-General for Health Systems and Innovation says "This list is a new tool to ensure R&D responds to urgent public health needs.Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time."
The high risk and medium risk category contains bacteria that are becoming increasingly drug resistant, and cause common illnesses such as gonorrhoea or food poisoning. Mr Hermann Gröhe, Federal Minister of Health, Germany says "We need effective antibiotics for our health systems. We have to take joint action today for a healthier tomorrow. Therefore, we will discuss and bring the attention of the G20 to the fight against antimicrobial resistance. WHO’s first global priority pathogen list is an important new tool to secure and guide research and development related to new antibiotics."
The list is meant as a guide for governments around the world to take appropriate policy measures that create the necessary conditions for further antibiotic research. There is an urgent need to incentivise research by both the private sector and organisations with public funding to focus future research to combat these dangerous families of bacteria. The list is meant as a guide for the various efforts around the world to develop new antibiotics.
WHO collaborated with the Division of Infectious Diseases at the University of Tubingen, Germany to prepare the list. An international group of experts checked the process for creating the list, which used a decision analysis technique based on multiple criteria.
The criteria used for selecting the bacteria included how deadly the infections caused by the pathogens were, whether the treatments of the conditions caused require long stays in hospitals and how frequently the bacteria families develop resistance to existing antibiotics. How easily the pathogens spread between animals, from animals to humans and in between humans was also a factor in selecting the most dangerous bacteria families known to man.
Other criteria for selection included whether the spread of the infections could be contained through good hygiene practices, vaccination or other means, the number of treatment options that remain, and if new antibiotics to tackle the problematic bacteria are already in research and development pipelines.
Prof Evelina Tacconelli, Head of the Division of Infectious Diseases at the University of Tubingen, says "New antibiotics targeting this priority list of pathogens will help to reduce deaths due to resistant infections around the world. Waiting any longer will cause further public health problems and dramatically impact on patient care."
One of the most notable exceptions from the list is Tuberculosis, caused by Mycobacterium tuberculosis (MTB). The MTB bacteria has killed the most number of people in human history, and is growing increasingly resistant to treatments. However, it was excluded from the list as other, more dedicated programs are closely taking the necessary steps to combat the deadly disease. Other bacteria excluded from the list such as streptococcus and chlamydia have low levels of resistance to existing treatments and are not a significant public health problem at this point of time.
The list was a result of member states of the WHO requesting a global pathogen priority list to help prioritise the research in new and effective treatments against dangerous bacteria. Currently, the prioritisation of antibiotic research by small and large pharmaceutical companies has been guided by market forces such as unmet medical need, market size, the potential for scientific advancement, pressure by investors or availability of technologies.
However, research and development alone is not sufficient to tackle the problem. The bacteria are likely to evolve further resistance to any new treatments that will be developed in the future as well. There needs to be more stress on prevention measures, and the existing treatments have to be used responsibly so as to contain the increasing resistance of bacteria to treatments. It will be necessary to carefully and rationally use any antibiotics developed in the future as well.
There are many measures that can be taken to contain the spread of deadly infections, apart from the development of new antibacterial treatments. Increased vaccination coverage, improved sanitation, and sustained implementation of infection control programs can all help reduce the threat to public health. These interventions will reduce the dependence on drugs, and hence slow down the development of drug resistance in bacteria. The report is available online (PDF).
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