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Superbugs That Threaten Global Health

The European Commission states that the overuse of antibiotics is becoming lesser; however, a report of increased European alert new antibiotic resistance is in process. This is compounded by the lack of new antibiotics in recent years; therefore, the experts make an international call to combat this serious problem.

Antibiotics do not kill viruses and although a survey just released by the European Commission says that more and more people internalize this message (and therefore less frequently used antibiotics unnecessarily), the reality is that such resistance of drugs remains one of the greatest threats to global health plans. The culprit is precisely the unnecessary and inappropriate use of these drugs.

‘It happens both in-hospital and at home. On one hand, people should not self-medicate and, secondly, doctors need training to improve the display of unnecessary antibiotics,’ argues Michael Sanchez member of the Infectious Diseases Working and Sepsis (GTEIS) of the Spanish Society of Intensive Care Medicine and Coronary Units (Semicyuc). ‘Through a culture could be determined whether it is a viral infection (where an antibiotic is not working) or bacterial (which does require antibiotic therapy), but the volume of queries and the time available for each patient is allowed to develop, so, on many occasions, such as preventive medicine and because the patient's request, in the end the doctor makes the antibiotic prescription’.

The pressure is especially noticeable in pediatric services, adds Jose Campos, National Center of Microbiology, Institute of Health Carlos III. ‘Parents, for fear that something happens and they see in the antibiotic antidote for their fever affected child, insist on this route indication’. Emphasizes, however, be noted that ‘the vast majority of respiratory problems in children are viral’. In fact, more than half of the children treated with antibiotics in respiratory processes do not need it, according to results of a study published in The Pediatric Infectious Disease Journal. The same occurs ‘in adults, most processes are viral’ said Campos.


Ineffective & Harmful To Viruses

In these cases, an antibiotic not only ineffective (or reduces the time and severity of infection) but ‘causes a great effect on the bacterial flora that we all have and need for the proper functioning of the immune system.’

The unnecessary use of these drugs causes bacteria increasingly develop resistance to drugs (providing mechanisms to resist the drugs used to combat them), to the point of becoming a kind of 'superbugs' unbeatable. That is, ‘some germs get to be almost completely immune to all available antibiotics’ (MDR), says Sanchez.

A particularly dangerous, both experts agree, in patients admitted to the Intensive Care Unit, with chronic diseases, who underwent surgery. In general, people with significant underlying diseases, when you acquire a resistant bacterial infection, argues Campos, ‘takes longer to heal because it is more difficult to treat. Sometimes we have to use combinations for which we have enough experience.’

In short, prolonging the duration of illness increases the morbidity and the risk of death. Moreover, as ‘infected patients persist longer, this encourages the spread of resistant microorganisms to others (it becomes an epidemic problem)’ and all this expensive medical care. According to the European Centre for Disease Prevention and Control (ECDC), in Europe some 25,000 deaths occur each year from incurable infection due to antibiotic-resistant bacteria and healthcare costs increased by more than 1500 million Euros.

Being aware of the gravity of the problem, both the World Health Organization as the most shaken by this global problem have been launched in the recent years  which is important to outreach and make awareness campaigns in order to reduce the abuse of antibiotics.

Increase The Resistance
Although it has managed to increase public awareness about it, still it is not enough as shown by the latest data released by the ECDC. ‘There has been a notable increase in resistant infections generation antibiotics’. Most tracks are produced by Gram-negative bacteria called Enterobacteriaceae, Klebsiella pneumoniae and E. coli, Pseudomonas and Acinetobacter), which also are the most frequent. Specifically, infections caused by Klebsiella pneumoniae resistant to carbapenems have increased between 2009 and 2012 by more than 5% in five countries, mostly in southern Europe.

These figures ‘show that antibiotic-resistant infections carbapenems are increasing in number and geographical distribution in Europe, which is a serious problem for many European hospitals,’ says Marc Sprenger, Director of ECDC. ‘It is necessary and urgent that all European countries incorporate national guidelines for hospitals to face up resistance to antibiotics and minimize as far as possible the impact on the health of patients.’

Do not forget that the problem of resistance joins ‘the shortage of new antibiotics in recent decades due to reduced economic investment, compared with chronic diseases’, as stated by the authors of a report by a panel of 26 experts and published in this week in the journal 'The Lancet'. ‘With the commitment and support of national and international politics, we must design innovative financing and sustainable models.’

Hygiene 
In Spain, it is being worked out on two lines. Campaigns aimed, first, the prudent and rational use of antibiotics both in primary care and in hospitals, and homes for the chronically ill. That is, ‘that they rely to antibiotics if necessary and with the right dose,’ says Dr. Campos. Of course, ‘you should never self-medicate’.

As for hospitals, says Sanchez, in recent years two national projects ('Zero Bacteria' and 'Pneumonia Zero') very significantly have reduced infections in ICUs (about 50%). They have achieved through measures such as hand washing health professionals between patients with the use of masks, gowns, gloves, hats, etc.

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