Superbug threat is 'ticking time bomb'

Superbug threat is 'ticking time bomb': There are claims across the media that antibiotic resistance is a ‘ticking time bomb’, with the Daily Express claiming “Superbug threat 'ranks alongside terrorism'”.

These headlines reflect the views of England’s Chief Medical Officer, and arguably could be viewed as understated.

The Chief Medical Officer, Professor Dame Sally Davies, warned of the growing threat from antibiotic resistance ahead of the publication of an in-depth report on the issue (PDF, 3.5MB). In her report, Professor Davies says antimicrobial resistance represents a threat that may be ‘as important as climate change for the world’.
Antimicrobials (drugs used to treat infections from bacteria, viruses and fungi) include antibiotics, which are an essential component of modern medicine and used to treat bacterial infections.
Increasingly widespread use of antimicrobials, and antibiotics in particular, is leading to the organisms causing these infections adapting and surviving. As this resistance develops, it can render treatment of infections less effective and eventually the infections may become untreatable.
Antibiotic-resistant infections, such as MRSA and multi-drug resistant tuberculosis have been increasing over the last two decades; yet few new antibiotics have been developed. While the spread of antimicrobial resistance can be slowed (for example, by good hygiene), new antibiotics are needed to more fully address the problem.

What is antibiotic resistance and how does it develop?

Antibiotics are often used to treat bacterial infections, and are a cornerstone of infectious disease care. They have transformed medical care since they became widely available after World War Two – resulting in a sharp drop in deaths from infectious disease.
However, bacteria evolve in response to their environment. Over time, they can develop mechanisms to survive a course of antibiotic treatment.
This ‘resistance’ to treatment starts as a random mutation in the bacteria’s genetic code, or the transfer of small pieces of DNA between bacteria. If the mutations are favourable to them, they are more likely to survive treatment, more likely to be able to replicate and therefore more likely pass on their resistant nature to future generations of bacteria. When taken correctly, antibiotics will kill most non-resistant bacteria, so these resistant strains can become the dominant strain of a bacteria. This means when people become infected, existing treatments may be unable to stop the infections.
We cannot stop the random DNA mutations that are one way antibiotic resistant strains of bacteria emerge. However, we can exert some control over the speed and spread of antibiotic resistance by several methods, such as:

• Breadth of use: the more antibiotics are used, the more quickly resistance generally develops, this makes reducing unnecessary use important (both in healthcare and other fields such as veterinary medicine).
• Incorrect use: resistance is more likely to spread if you do not finish a course of antibiotic treatment (as the drugs won’t have a chance to kill off all the bacteria), or if broad-spectrum antibiotics, which often serve as ‘last-line’ treatments, are used where a more narrow and targeted option is available and appropriate.
• Infection control: containing and preventing infectious diseases – such as through diligent cleaning and hand washing – can reduce the need for antibiotic use. 

How much of a danger is antibiotic resistance?

Antibiotic resistance can render previously treatable infections untreatable. For instance, tuberculosis (TB) cases have been increasing steadily in the UK for the past 20 years, with an increasing number of cases being resistant to the first-choice antibiotics traditionally used to treat the infection.
Widespread antibiotic resistance could have a far reaching healthcare impact. For example, emerging antibiotic resistance increases the chance that surgical sites could be infected by bacteria resistant to antibiotics and cause infection in people who may already be vulnerable as a result of their underlying illness or from having major surgery.
The Chief Medical Officer says that other treatments which lower our immune response – including immunosuppressants (for example, to prevent the body rejecting transplanted organs) or chemotherapy for cancer – would also not be viable in the face of widespread antibiotic resistance. 
Professor Davies, has said that “antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics. And routine operations like hip replacements or organ transplants could be deadly because of the risk of infection”.

Links To The Headlines

Antibiotics resistance 'as big a risk as terrorism' - medical chief. BBC News, March 11 2013
New wave of 'superbugs' poses dire threat, says chief medical officer. The Guardian, March 11 2013
Resistance to antibiotics risks health 'catastrophe' to rank with terrorism and climate change. The Independent, March 11 2013
Threat posed by resistance to antibiotics 'ranks alongside terrorism'. The Daily Telegraph, March 11 2013
Superbugs 'will send the health service back to 19th century': Even routine surgery could become deadly, warns top medical adviser. Daily Mail, March 11 2013
Warning issued over superbug threat. Channel 4 News, March 11 2013
Antibiotics resistance as big a risk to Britain as terrorism, claims medical chief. Metro, March 11 2013
Antibiotic Resistance 'A Ticking Time Bomb'. Sky News, March 11 2013
NHS Choices