Bacteria becoming completely resistant to ‘last resort’ antibiotics, or polymyxins, due to a mutation has been discovered in China, a study conducted by the South China Agricultural University and Cardiff University amongst others has revealed. The study was published yesterday in The Lancet Infectious Diseases, a UK-based monthly journal of medical research and review relating to clinical infectious diseases worldwide.
It has been dubbed the ‘Antibiotic Apocalypse’.
Professor Colin Garner, chief executive of Antibiotic Research UK, said: “The term ‘apocalypse’ is appropriate because we will lose all the benefits that antibiotics provide and medicine could be plunged into the dark ages. Travel would be out of the question, childbirth would be dancing with death, paper cuts and other minor infections would kill once again, whilst surgery and caner therapies, which rely upon antibiotics, would be under severe threat. This is the future humanity faces when antibiotics stop working – and scientists say we are approaching a doomsday scenario.”
The study found the resistant bacteria in pigs, raw pork samples and 16 human patients in China. The mutation that made the bacteria resistant to the drug is called the MCR-1 gene. Found on plasmids or mobile DNA strands that can be easily copied between different bacteria, suggesting an “alarming potential” for it to spread across diverse bacterial populations including polymyxins such as colistin. In 2012, the World Health Organisation classified colistin as being critically important for human health.
The team from the institutions were first alerted to the possibility after a pig in a farm in Shanghai showed resistance to colistin in 2011. Over the next four years they took samples from pigs at slaughter across four provinces, and meat sold in markets concluding that there was a high prevalence of the MCR-1 gene in E coli, with the proportion of positive samples increasing each year. The mutated forms were also found in 1322 hospitalised patients in China and is thought to have already spread to Laos and Malaysia. Researchers say it is just a matter of time before it goes global. The concern is that the new resistance gene will hook up with others plaguing hospitals, leading to bacteria resistant to all treatment – what is known as pan-resistance.
It is over-use of antibiotics that has been blamed for the growth of resistant bacteria, with government calls for doctors to hand the drugs out less falling on deaf ears.The more an antibiotic is used, the more pressure is put on bugs to evolve resistance to them – and the quicker the drugs are rendered obsolete as new superbugs emerge.
In the European Union, colistin is used in only veterinary medicine. In China, however, it is used routinely to promote growth, especially in pigs. The Chinese Government has already banned vets from using colistin and the researchers are hoping the same prohibition will be applied globally. Early indications suggest the Chinese government is also moving swiftly to address the current situation.
“We need much more investment,” says Laura Piddock, director of Antibiotic Action. “It costs 500 million US dollars to go from discovery of a drug to using it on patients. Yet the pot of UK funding is worth £20 million. People at the top really need to decide whether this is a priority or not.”
The economist Jim O’Neill has called for a $2 billion (£1.3 billion) global innovation fund to support research into new antibiotics.
Dr. Bruce Hirsch, infectious disease specialist at North Shore University Hospital in New York asserted that doctors and patients should also understand the increasing responsibility to reduce antibiotic intake.
“If you don’t need antibiotics, don’t take them. You are only giving bacteria extra practice,” he told HealthDay.
Yesterday Public Health England called for NHS patients to become Antibiotic Guardians, and think carefully before asking for drugs and take more care to prevent the spread of infections by washing hands and accepting the flu jab.
“If MRC-1 becomes global, which is a case of when not if, and the gene aligns itself with other antibiotic resistance genes, which is inevitable, then we will have very likely reached the start of the post-antibiotic era,” Timothy Walsh, a professor at University of Cardiff who worked on the study, told the BBC.
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