The stark impact of antimicrobial resistance is all around us. Just a few weeks ago, a woman in the US who could not be treated with any available antibiotics (26 to be precise) died. And recently, results of a study demonstrated that four patients had malaria that was resistant to the most commonly used antimalarial in the UK. Similarly, we are seeing outbreaks of both gonorrhoea and fungal infections that are multi-resistant.
The failure of treatment for gonorrhoea has been confirmed in at least 10 countries including the UK, Australia, Canada and France.
Antimicrobial resistance is more common in some parts of the world than others. For example, it was estimated that there were 214,000 neonatal deaths attributable to resistant sepsis infections globally in 2013. 111,523 of these occurred in the five countries with the highest numbers of neonatal deaths in the world: India, Pakistan, Nigeria, Democratic Republic of Congo and China.
A major area of concern for health professionals is drug-resistant tuberculosis. The World Health Organisation estimates that in 2014, there were about 480,000 new cases of multi-drug resistant tuberculosis (MDR-TB), a form of tuberculosis that is resistant to the two most powerful anti-TB drugs. Soaring rates of multi-drug resistant tuberculosis have been found in west Africa, with the highest in the dense population of Lagos, Nigeria, suggesting the seriousness of the epidemic has been considerably underestimated.
Although there is a lot of talk about antibiotic resistance in the future, it is important to realise that we are already seeing the impact of resistant infections in everyday life. Many urinary tract infections are becoming resistant, which can lead to people requiring a hospital stay. Sally Davies, chief medical officer for England, warned last year that 50,000 people are dying every year in Europe and the US from infections that antibiotics have lost the power to treat.
Resistance is not a new problem. Alexander Fleming (1881–1955), who discovered penicillin, warned of the risk of resistance developing as far back as 1945. During his Nobel prize speech in 1945 he said: “The microbes are educated to resist penicillin and a host of penicillin-fast organisms is bred out which can be passed on to other individuals and perhaps from there to someone else and to others until they reach someone with a pneumonia which penicillin cannot save. I hope this evil can be averted.”
Having fewer antibiotics that work will be equivalent to going back to the early 1930s, where infections we now consider trivial thanks to quick treatment by antibiotics will once again be fatal. An infected cut or illness such as pneumonia could once again become mass killers. Resistance is an…