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A public health emergency is waiting at the bottom of the antibiotic resistance cliff

MedicalXpress Breaking News-and-Events Dec 31, 2024

The rise of antibiotic-resistant bacteria could lead to a catastrophic rise in infection-related deaths, according to new research led by Northern Arizona University.

The question likely isn't whether it will happen, but when, the lead author has warned.

The study, published in Communications Medicine, paints a bleak picture of public health in the coming decades. As the use of antibiotics has increased worldwide, bacteria have become increasingly resistant to many different antibiotics, known as multidrug-resistance. That puts the entire global population at increased risk of death from infection.

"Multidrug-resistance is bad, but once a pathogen gains resistance to all known antibiotics, known as pan-resistance, a dramatically rapid shift, rather than a gradual rise in public health impacts, can be expected," said lead author Benjamin Koch, senior research scientist at NAU's Center for Ecosystem Science and Society (Ecoss).

"This research assesses the likely speed and magnitude of those expected impacts and essentially says, 'Hold up, this problem could rapidly become orders of magnitude worse than we've been planning for.'"

Ecoss director and Regents' professor of biology Bruce Hungate was also a co-author, along with researchers from the Milken Institute School of Public Health at George Washington University and the University of Minnesota.

What researchers found

The researchers modeled the impact of one hypothetical pan-resistant strain of E. coli on sepsis deaths in the United States using long-term data on incidence, mortality rates and treatment outcomes. The models, looking at a spectrum from conservative to aggressive potential results, showed that sepsis deaths could increase by 18 to 46 times just five years after the introduction of such a strain.

That strain doesn't exist—yet—but the rate at which bacteria are evolving and gaining pan-resistance means it is coming. With the available data, researchers aren't able to predict the timing of pan-resistance with any accuracy; it could be in a year, Koch said, or it could be in a century.

What this means and why you should care

Pan-resistant bacteria will adversely affect every population. This is actually rather unusual. Typically, people in high-income countries have access to higher-quality health care, so when they get an infection, they can access different kinds of antibiotics. However, antibiotic pan-resistance erases those advantages, and more people throughout the globe will die from previously treatable infections.

That's the bad news. The good news is there are actions that governments, industry and individuals can take to reduce the risk and slow antibiotic resistance. That includes governments strengthening policies around the safe use of existing antibiotics in both food-animal and health care industries and incentivising the development of new antibiotics. There are also technologies that could monitor the emergence and spread of antibiotic resistance.

On an individual level, Koch said, people should use antibiotics only when necessary as directed by a health care provider, and should support policies that strengthen the stewardship of existing antibiotics and promote the development of new antibiotics, a process that has slowed to a virtual halt in recent years.

"We must reduce the forces that currently promote the evolution and dissemination of antibiotic-resistant pathogens," the authors wrote. "Globally, this means improving antibiotic stewardship in human and veterinary medicine and in food-animal production."

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