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WHO releases list of drug-resistant bacteria

LiveMint logoLiveMint 27-02-2017 Isha Trivedi

The World Health Organization (WHO) on Monday released a list of 12 families of bacteria that have become resistant to antibiotic medicines and pose significant threat to human health.

The list was drawn up in a bid to guide and promote research and development (R&D) of new antibiotics, as part of WHO’s efforts to address growing global resistance to antimicrobial medicines.

There are certain types of bacteria that have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well, WHO said in a press release.

“This list is a new tool to ensure R&D responds to urgent public health needs. Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time,” Marie-Paule Kieny, WHO’s assistant director-general for health systems and innovation, said.

The WHO list is divided into three categories according to the urgency of need for new antibiotics—critical, high and medium priority.

The most critical group includes multi-drug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include acinetobacter, pseudomonas and various enterobacteriaceae, which can cause severe bloodstream infections and pneumonia.

These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins—the best available antibiotics for treating multi-drug resistant bacteria.

The second and third tiers in the list—the high and medium priority categories—contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhoea and food poisoning caused by salmonella.

“The list is intended to spur governments to put in place policies that incentivize basic science and advanced R&D by both publicly funded agencies and the private sector investing in new antibiotic discovery,” WHO said in the release.

Tuberculosis, whose resistance to traditional treatment has been growing in recent years, was not included in the list because it is targeted by other, dedicated programmes.

The list was developed in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany. The selection of pathogens on the list was based on how deadly the infections they cause are; whether their treatment requires long hospital stays; how frequently they are resistant to existing antibiotics; how easily they spread; whether they can be prevented; how many treatment options remain; and whether new antibiotics to treat them are already in the R&D pipeline.

WHO emphasized that higher R&D alone cannot solve the problem and there must be better prevention of infections, appropriate use of existing antibiotics in humans and animals, as well as rational use of new antibiotics that are developed in future.

Antimicrobial resistance is of particular concern in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. India has among the highest bacterial disease burden in the world.

On 1 February, the Central Drugs Standard Control Organisation, the apex drug regulating agency in India, released an advisory for rational use of antibiotics for limiting antimicrobial resistance. The agency said that such indiscriminate use of antibiotics may be due to easy availability of prescription drugs, and injudicious use in hospitals as well as uncontrolled use in agriculture, animal husbandry and fisheries.

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