As Cases of Superbug Infections Multiply, Do We Need to Develop a New Approach to Pathogen Control in Healthcare?
An unwelcome trend that’s well-known to the healthcare community is that dangerous bacterial pathogens are evolving and spreading faster than we can treat them with antibiotics.
In many cases, the bacteria are developing antimicrobial resistance (AMR) to nearly all commonly available first-line antibiotic treatments, making it more challenging for healthcare providers to treat diseases such as sepsis, tuberculosis, syphilis, and gonorrhea.
Adding to the challenge is the rise of multidrug-resistant organisms (MDROs), which can’t be controlled by two or more drug categories. These pernicious MDROs, such as MRSA (Methicillin-resistant Staphylococcus aureus) and CRAB (Carbapenem-resistant Acinetobacter baumannii), are often found in healthcare settings, where they can infect patients during a hospital stay (known as hospital-acquired infections, or HAIs).
Antimicrobial Resistance (AMR) Kills 3,500 People a Day, Making it a Leading Cause of Death Worldwide
According to research published in The Lancet that evaluated the health outcomes of 23 pathogens and 88 pathogen/drug treatment regimens across 204 countries, there were nearly 5 million deaths worldwide that were associated with antibiotic-resistant bacterial infections in 2019; of that figure, 1.2 million deaths were directly caused by AMRs.
These figures are very sobering and compare unfavorably to other high-mortality diseases, such as HIV (estimated to have caused 860,000 deaths) or malaria (which resulted in 640,000 deaths) during the equivalent period.
Are We headed to a Post-Antibiotic World?
Given the uncomfortably high rate at which pathogens are developing resistance to drug treatment regimens, what can we expect in the future?
Some healthcare analysts believe we should be planning for the coming “post-antibiotic” world (arriving perhaps as soon as 2050) if current trends continue.
Researchers Kristofer Hansson and Adam Brenthel published a paper in the Boston Medical Journal’s Medical Humanities that sounds a warning that our collective lack of action in dealing with this issue will certainly lead to a dark future in healthcare.
The costs could be tremendous as well, both in lives lost and in increased healthcare spending. One study estimates that by 2050, 10 million will die annually due to a lack of available treatments, while another published report estimates that by 2050, the additional cost of treating AMR infections could balloon to between $300 and $1 billion annually.
Can Disease Treatments Ideas from the Pre-Antibiotic Era Provide Inspiration for New Care Approaches?
Given this five-alarm fire scenario, laboratory researchers around the world are pursuing many different approaches to solve the drug resistance problem, from investigating exotic new organisms to using gene therapy to create new antibiotics. We applaud all these efforts, and, given the scope of the problem, it will most likely take more than one solution to solve the growing problem of AMR.
One approach that caught our eye is an old concept that pre-dates the penicillin era – it’s known variously as phage therapy, viral phage therapy, or phagotherapy.
Could Injecting Bacterial Enemies (Bacteriophages) Help Cure Hard-to-Treat Bacterial Infections?
Since their discovery, antibiotics have proven to be so incredibly successful in transforming healthcare that we seem to have brushed aside earlier approaches under study during the pre-antibiotic era.
One such therapeutic approach, first identified in 1915 and seen as a promising treatment during the early years of the 20th century, is the use of bacteria-killing bacteriophage viruses to “kill” disease-causing bacteria.
In other words, instead of using antibiotic drugs that are toxic to bacteria, why not employ a specific virus known to kill a particular type of bacteria?
Interest in this approach has been on the rise in recent years, and researchers are considering the possibility that bacteriophages could replace antibiotics in the future.
Phage therapy has a key advantage over traditional antibiotics – they are not likely to lead to drug resistance, and they tend to be very targeted, only affecting specific types of bacteria. This could be an advantage compared to antibiotics, which often indiscriminately kill off “good” bacteria when treating “bad” bacteria. The downside is that patients with multiple types of bacterial infections could need a specific phage treatment for each type of infection.
If you are interested in reading more about phage therapy, we can suggest the book The Perfect Predator: A Scientist’s Race to Save Her Husband from a Deadly Superbug: A Memoir. In this gripping story, epidemiologist Steffanie Strathdee battles to save the life of her husband, the psychologist Tom Patterson, who contracted one of the most dangerous, antibiotic-resistant bacteria in the world during a trip to Egypt. Desperate for a cure, Strathdee came across earlier research in phage therapy and convinced hospital laboratory clinical staff to isolate a matching bacteriophage, which ultimately killed off the highly resistant infection, saving the life of her husband.
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