World headed for 'apocalyptic' post-antibiotic era, WHO warns

The threat posed by antibiotic resistant bacteria is a real and present one, the World Health Organization warns.

Antibiotic resistance occurs when some bacteria change, rendering drugs that are meant to kill them useless or ineffective. Those bugs then survive and spread the resistance.

Wednesday's report from the United Nations health agency showed antibiotic resistance in microbes that cause common and serious diseases such as urinary tract infections and pneumonia in all regions of the world.

Adriano Picente is a medical laboratory technologist working in Dr. Andrew Simor's lab at Toronto's Sunnybrook Health Sciences Centre, where they are studying the hospital-acquired infection MRSA. (Melanie Glanz/CBC)

"What it means, is that all of us, our family members, all of the persons in this room, our friends, when we are most vulnerable and in need of these medicines, there is a chance that they are simply not going to be available and we are not going to be able to have access to effective medical care in a number of instances," Dr. Keiji Fukuda, one of the agency's assistant directors-general, told reporters.

In many countries, treatments for drug-resistant E. coli that cause problems such as meningitis and infections of the skin, blood and kidneys, no longer work in more than half of patients, according to the report.

The situations differ depending on the country.

"A post-antibiotic era, in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century," Fukuda said in the forward of the report.

"We already see cases where treatment has failed," Dr. Johan Struwe of the WHO's antimicrobial resistance team said in an interview. "It's reported in tuberculosis; there are countries reporting untreatable gonorrhea as a result of drug resistance and it's well known in malaria where it's been around for quite a long time. So we see it already."

Dr. Andrew Simor, head of microbiology at Toronto's Sunnybrook Health Sciences Centre, said the major resistance threats at his hospital and likely other Canadian hospitals are C. difficile and MRSA. Multi-drug-resistant germs called CRE (carbapenem-resistant Enterobacteriaceae) are still uncommon but on the rise.

Some countries have been aggressive in terms of surveillance for antibiotic resistance, which the WHO says is important for early detection of resistant strains in addressing public health concerns and to inform clinical decision-making, for example by doctors and staff in nursing homes.

"In my view here in Canada, we have had real success but modest as compared to Scandinavia and Europe [but] we are clearly doing better," Simor said. "I think our control measure have been only wishy-washy compared to what they do. I don't think we have as comprehensive or as effective national surveillance in place."

Infection control methods in Canada are good but could be a lot better, he said.

'We have to stop our love affair with antibiotics.'- Dr. Michael Gardam of the University Health Network in Toronto

To stop outbreaks in hospitals, doctors first need to know where they're happening, said Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto.

"We have to stop our love affair with antibiotics," Gardam said. "It's so easy to give them, We have to start thinking of these drugs as not only are they not benign but also we're running out of them."

Canadian experts said governments have to find ways to encourage research and development into new antibiotics and prevention and treatment approaches given that pharmaceutical companies don't have a financial incentive to develop new drugs for infections that just last for a week or two.

The WHO said other important actions include preventing infections from happening in the first place through better hygiene, access to clean water, infection control in health-care facilities, and vaccination to reduce the need for antibiotics.

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