Superbug syndrome

A superbug, resistant to all known antibiotics that can cause “severe” infections or even death is spreading undetected through hospital wards across the world.

Background

"Superbug" is a term used to describe strains of bacteria that are resistant to the majority of antibiotics commonly used today. Antibiotic resistance is a naturally occurring phenomenon that can be slowed, but not stopped. Over time, bacteria adapt to the drugs that are designed to kill them and mutate to ensure their survival.

A World Health Organization (WHO) report released on April 2014 stated, "this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance—when bacteria change so antibiotics no longer work in people who need them to treat infections—is now a major threat to public health.”

Analysis

Researchers at the University of Melbourne discovered three variants of the multidrug-resistant bug in samples from 10 countries, including strains in Europe that cannot be reliably tamed by any drug currently on the market. “We started with samples in Australia but did a global snapshot and found that it’s in many countries and many institutions around the world,” said Ben Howden, director of the university’s Microbiological Diagnostic Unit Public Health Laboratory.

The bacteria, known as Staphylococcus epidermidis, is related to the better-known and deadlier MRSA. It’s found naturally on human skin and most commonly infects the elderly or patients who have had prosthetic materials implanted, such as catheters and joint replacements.

Experts have looked at hundreds of S. epidermidis specimens from 78 hospitals worldwide. They found that some strains of the bug made a small change in its DNA that led to resistance to two of the most common antibiotics. “These two antibiotics are unrelated and you would not expect one mutation to cause both antibiotics to fail,” said Jean Lee, a PhD student at Melbourne’s Doherty Institute, and co-author of the study.

Many powerful antibiotics are extremely expensive and even toxic, and the team behind the study said that even the practice of using multiple drugs at once to prevent resistance may not be working. The researchers said they believe the superbug is spreading rapidly due to the particularly high use of antibiotics in intensive care units.  ICU patients are usually the sickest and strong drugs are prescribed as routine.

The World Health Organization has long warned of antibiotic overuse sparking new strains of killer, drug-resistant bacteria. Another Australian study, published last month, suggested some hospital superbugs are growing increasingly tolerant to alcohol-based disinfectants found in hand-washes and sanitizers used on hospital wards.

A proposed solution is a global antimicrobial resistance policy, which is uniform in its approach to any future “superbug” outbreak. Global antimicrobial resistance policies could take lessons from the environmental sector by adopting strategies that have made international environmental agreements successful in the past. These include sanctions for non-compliance, assistance for implementation, majority vote decision-making rules, an independent scientific panel, and specific commitments.

Assessment

Our assessment is that a ‘superbug’ outbreak is impossible to predict and hence we need a global, legal framework to prevent and control antimicrobial resistance. We believe that there is a need to create antimicrobial use standards, regulate antibiotic marketing, and strengthen global surveillance systems. We feel that simple, regulatory standards could prevent a mass outbreak which could kill millions.