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Superbugs already kill more than cancer, AIDS and malaria

2022-01-20T00:13:02.814Z


The largest study to date warns that 1.2 million people die each year from antibiotic-resistant infections, a number that will multiply by 10 in 2050


Today the most complete data to date of a pandemic that has been underway for years and that threatens to become a much greater nightmare than covid is published: deaths caused by antibiotic-resistant bacteria.

Infections caused by these pathogens worldwide take 1.2 million lives a year, more than AIDS, malaria or cancer of the lung, trachea and bronchi. In addition, this type of microbe also infected almost five million people who died in hospitals from other causes. Those responsible for the study consider that in less than 30 years, superbugs will kill 10 million people each year, that is, three times more than the estimate for covid in 2020. The research has been published in the medical journal

The Lancet

and has analyzed data from 204 countries, the most comprehensive study of its kind to date, according to its authors

The most worrying thing about these data is that there is hardly any cure for these deadly infections. There is only one vaccine for one of these pathogens. In the rest of the cases, doctors are often helpless, as the bacteria have become immune to all first-line antibiotics, such as penicillin. The cause of this "enormous threat to global health", as the authors of the mega-study describe it, is the indiscriminate and careless use of antibiotics since the second half of the last century, both in human health and in livestock to fatten cattle.

The world is today much closer to reaching the expected death toll within 30 years than previously thought, warns Chris Murray, a researcher at the University of Washington (USA) and co-author of the study. In addition, it has differentiated between deaths directly attributable to infections from those in which these microbes were related to deaths, but it could not be ensured that they were responsible. "We have to act now against this enormous threat," Murray warned.

Antibiotic-resistant infections are already the third leading cause of death globally, only behind coronary heart disease and stroke, the study highlights. Respiratory infections such as pneumonia caused by these bacteria are the ones that cause the most mortality: 400,000 deaths a year. They are followed by blood infections that can lead to sepsis - which claim 370,000 lives - and abdominal infections, which take another 210,000.

The data available until now were more fragmentary and incomplete. One of the great contributions of this study is to consider both deaths due to resistant infections and people who died with an infection of this type even though this was not the main cause of death. Researchers have looked at 23 different pathogens and nearly 90 combinations of infections and drugs used to treat them — without success.

Children are the most affected by this pandemic: 20% of the deceased were under five years old, according to the study, which does not detail deaths in other age groups.

Young children are more vulnerable to these infections because their immune systems are not yet trained and they are in contact with more pathogens because they spend a lot of time on the floor and put many objects in their mouths.

In fact, Unicef ​​estimates that up to 40% of all deaths in these ages are due to resistant infections.

Of all the microbes tested, just six of them —

E. coli, S. aureus, K. pneumoniae, S. pneumoniae, A. baumannii, and P. aeruginosa

— are responsible for the majority of deaths (920,000).

Sub-Saharan Africa and Southeast Asia are the two regions with the highest incidence, with more than 20 deaths per 100,000 inhabitants. In developed countries, including Spain, infections of this type kill 13 people out of every 100,000 on average. Spain shows average levels of resistance to antibiotics, higher than those of the countries of the north of the EU and lower than those registered in some of the south, such as Italy, Portugal or Greece. The bacterium that most threatens Spain is

Acinetobacter baumannii,

according to the work data. This microbe especially affects patients hospitalized in the ICU.

Mortality caused by these microbes could be much lower if there was access to the right medicines. 70% of deaths are due to bacteria that are only immune to first-line antibiotics, such as fluoroquinolones, but not to more expensive ones used in cases of resistance.

Microbiologist Bruno González Zorn highlights the importance of this study for its "reliability" in showing the real dimensions of this "silent pandemic".

“It is very difficult to quantify the real deaths from these infections, it is not as clear as in covid or tuberculosis.

That is why the numbers of previous studies danced quite a bit, ”he explains.

“Until now, some 700,000 deaths per year were estimated, but as many countries as in this new study were not taken into account, which above all provides clarity about what is happening in developing countries,” González highlights.

This researcher is part of a scientific team that the World Health Organization has commissioned to select the list of essential antibiotics for human health and shield their use, which would prevent bacteria from becoming resistant to them.

The expert points out a bleeding aspect that exposes the work. In developing countries there is no widespread access to antibiotics of last resort. These are more expensive medicines and are only administered intravenously and in hospitals. This causes many people to die from infections that would be curable in Europe, for example.

This is not a problem only for poor countries, but also for rich ones, explains the scientist. “Due to lack of access, there is a growing black market for antibiotics that do not meet quality standards and do not fully cure infections. I myself have seen them for sale in markets in India, for example. As they are not totally effective, they allow bacteria to develop new resistance genes and sooner or later these variants end up reaching the whole world”, he details. In the opinion of this biologist, the pandemic “is accelerating”. “Covid has made the situation worse and will make it even worse. The pandemic has increased the number of hospital admissions which, added to the misuse of antibiotics in hospitals, especially in Latin America and Africa,they end up generating more deaths from infections and more resistant variants,” he highlights.

The authors of the work call for urgent measures to promote the proper use of antibiotics, improve asepsis in hospitals to prevent infections and finance the search for new antibiotics. This last objective is much more complex than it seems, since it is not interesting for the pharmaceutical industry, explains Rafael Cantón, head of Microbiology at the Ramón y Cajal Hospital in Madrid. "Companies do not want to make the large outlay involved in developing a new drug so that shortly after it is released on the market, new resistances appear and it ceases to be effective," he explains. Cantón cites examples such as Achaogen, a US company that launched into the development of new antibiotics and ended up going bankrupt. In addition, large multinationals such as Novartis have abandoned their projects in this field.“We have to find new ways to finance the development of antibiotics just as we have done with covid vaccines,” says Cantón.

González Zorn believes that this problem can only be solved with global measures - the so-called One Health approach, which encompasses the health of humans and the planet - involving all the actors: doctors, veterinarians, economists from the including sociologists, so that they can get the message across that antibiotics should not be misprescribed. “A third of all antibiotics are prescribed inappropriately. It is necessary to teach the prescribers and educate the population”, he highlights.

The dimensions of this pandemic are inversely proportional to the money spent on fighting it, warns Ramanan Laxminarayan, director of the Center for Disease Dynamics, in the US, an institution specializing in public health and health economics, in a commentary on the study. . “Antibiotic resistance is no longer an ignored problem and we now know its true dimensions, thanks to this study. The estimated number of deaths is much higher than that caused by HIV, which attracts some 50,000 million euros in research each year. Probably, the funds dedicated to fighting the resistance are much lower”, he ventures.

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Source: elparis

All news articles on 2022-01-20

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