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

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

The question is probably not if it will happen, but when, the lead author warns.

The study, published in Communication medicinepaints 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. This puts the entire world population at increased risk of death from infection.

“Multidrug resistance is bad, but once a pathogen acquires resistance to all known antibiotics, known as pan-resistance, a dramatically rapid change can be expected, rather than a gradual increase in public health consequences,” said lead author Benjamin Koch. senior research scientist at NAU’s Center for Ecosystem Science and Society (Ecoss).

“This study assesses the likely speed and magnitude of those expected impacts and essentially says, ‘Wait a minute, this problem could quickly become orders of magnitude worse than we planned.'”

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 discovered

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, which looked at a spectrum of conservative to aggressive potential outcomes, showed that deaths from sepsis 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 speed at which bacteria develop and acquire pan-resistance means it is coming. With the available data, researchers are unable to predict the timing of pan-resistance with any accuracy; It could be a year from now, Koch said, but it could also be a century from now.

What this means and why you should care

Pan-resistant bacteria will negatively affect any population. This is actually quite unusual. Typically, people in high-income countries have access to higher quality healthcare, so if they get an infection, they have access to different types of antibiotics. However, pan-resistance to antibiotics is negating these benefits, and more and more people around the world will die from previously treatable infections.

That’s the bad news. The good news is that governments, industry and individuals can take actions to reduce the risk and slow antibiotic resistance. This includes governments strengthening policies around the safe use of existing antibiotics in both the animal feed and healthcare sectors and encouraging the development of new antibiotics. There are also technologies that can monitor the emergence and spread of antibiotic resistance.

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

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