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antibiotic

Antibiotic Resistance Hits Crisis Levels, WHO Reports

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The World Health Organization (WHO) has issued a stark warning about the surging spread of drug-resistant bacteria, threatening the effectiveness of vital antibiotics and making once-treatable infections increasingly dangerous.

According to new data released Monday, one in six bacterial infections confirmed by laboratories worldwide in 2023 showed resistance to commonly used antibiotics.

“These findings are deeply concerning,” said Yvan J-F. Hutin, who heads the WHO’s department for antimicrobial resistance.

“As antibiotic resistance continues to rise, we are running out of treatment options and we are putting lives at risk, especially in countries where infection prevention and control is weak and access to diagnostics and effective medicine is already limited.”

The WHO report, based on five years of surveillance data, paints a grim picture: resistance rose in more than 40% of the antibiotics it tracked between 2018 and 2023, with yearly increases ranging from 5% to 15%.

Antimicrobial-resistant (AMR) infections now directly kill over a million people annually and contribute to nearly five million deaths worldwide, the organization said. The agency examined 22 antibiotics used to treat infections of the urinary tract, bloodstream, and gastrointestinal system, as well as gonorrhea, and found widespread resistance.

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For urinary tract infections alone, resistance to widely prescribed antibiotics exceeded 30% in most regions.

Among the eight pathogens examined, including E. coli and K. pneumoniae, resistance has become alarmingly common. More than 40% of E. coli infections and 55% of K. pneumoniae infections are now resistant to third-generation cephalosporins, the standard first-line treatment.

“Antimicrobial resistance is outpacing advances in modern medicine, threatening the health of families worldwide,” said WHO Director-General Tedros Adhanom Ghebreyesus.

The WHO said antibiotic resistance was highest in regions with weaker healthcare systems and limited laboratory capacity. In Southeast Asia and the Eastern Mediterranean, one in three infections showed resistance, while in Africa, one in five did.

Silvia Bertagnolio, who leads WHO’s AMR surveillance unit, said these systems often lack the capacity to diagnose or treat infections effectively. She added that limited surveillance in some countries means data is often collected only from the sickest patients, skewing resistance figures upward.

While global surveillance has improved, 48% of countries still report no data at all. “We are definitely flying blind in a number of countries and regions,” Hutin admitted.

Overuse and misuse of antibiotics in humans, animals, and agriculture continue to drive resistance, allowing bacteria to evolve faster than new treatments can be developed. The WHO warned that the global drug pipeline — the number of new antibiotics in development — remains alarmingly thin.

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“The increasing antibiotic use, the increasing resistance and the reduction of the pipeline is a very dangerous combination.”

The situation isn’t limited to developing regions. In the United States, the Centers for Disease Control and Prevention reported last month that infections from drug-resistant “nightmare bacteria” jumped nearly 70% between 2019 and 2023.

Dr Manica Balasegaram at the Global Antibiotic Research and Development Partnership said the report shows how drug-resistant infections have reached “a critical tipping point”.

“The most difficult-to-treat gram-negative infections are now beginning to outpace antibiotic development, either because the right antibiotics are not reaching the people who need them, or because they are not being developed in the first place.”

The WHO called for urgent global action, including better monitoring, stricter antibiotic stewardship, and investment in new treatments. Without these steps, even minor infections or routine surgeries could become life-threatening.

“It’s not enough to develop new antibiotics; they have to be the right ones, those that target infections that have the greatest public health impact. We are failing to replace the antibiotics that are being lost to resistance, and this latest WHO report shows that the consequences of that are now finally beginning to be felt,” he said.

“Until now, the AMR narrative has focused rightfully on the overuse of antibiotics, but this isn’t enough. To avoid the tipping point, we must now also focus efforts on accelerating innovation and increasing their appropriate use.”

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Scientists Develop New Antibiotic to Kill Drug-Resistant Bacteria

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Scientists have developed a novel antibiotic to combat bacteria resistant to existing antibiotics. The bacteria, Acinetobacter baumannii, causes infections in the lungs, urinary tract and blood and has a high mortality rate.

The US Centers for Disease Control and Prevention (CDC) report that it is resistant to a class of broad-spectrum antibiotics known as carbapenems, and it kills a significant number of people via invasive infection.

In 2017, the World Health Organization released a list of antibiotic-resistant “priority pathogens,” listing Carbapenem-resistant Acinetobacter baumannii (CRAB) in its critical category. The organization describes pathogens of this designation as “ multidrug-resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters.”

Data from the CDC shows that the bacteria caused 700 fatalities and 8,500 infections in hospitalized patients in the US that year. Being a Gram-negative bacteria, protected by inner and outer membranes, makes CRAB incredibly difficult to treat. The US Food and Drug Administration has not authorized a new class of antibiotics to treat it in over 50 years.

However, Acinetobacter baumannii can be effectively killed with the new antibiotic Zosurabalpin, according to researchers from Harvard University and the Swiss healthcare company Hoffmann-La Roche.

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Dr. Kenneth Bradley, one of the researchers and global head of infectious disease discovery with Roche Pharma Research and Early Development, stated that the drug is in its own chemical class and has a unique method of action.

The study’s primary objective was to discover and optimize a molecule capable of penetrating bacterial double membranes and killing them. “These two membranes create a very formidable barrier for entry of molecules like antibiotics,” he said.

“This is a novel approach, both in terms of the compound itself but as well as the mechanism by which it kills bacteria.”

The research found that Zosurabalpin was effective against over 100 CRAB clinical samples. To develop the drug, the scientists researched 45,000 small antibiotic molecules known as tethered macrocyclic peptides to find those that could inhibit bacterial growth. Researchers spent years honing the effectiveness and safety of a select few compounds before settling on a single modified molecule.

By blocking the transport of lipopolysaccharides, which are big molecules essential for maintaining the integrity of the outer membrane and ultimately leading to cell death, Zolofalacpin inhibits the growth of Acinetobacter baumannii.

According to the study, the antibiotic significantly decreased bacterial levels in mice with CRAB-induced pneumonia. Additionally, it prevented the death of mice infected with bacterial sepsis.

“Drug discovery that targets harmful Gram-negative bacteria is a long-standing challenge owing to difficulties in getting molecules to cross the bacterial membranes to reach targets in the cytoplasm. Compounds typically must possess a certain combination of chemical characteristics.”

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Dr. Michael Lobritz, the global head of infectious diseases at Roche Pharma Research and Early Development and an associate participant in the study, stated that the continued absence of effective treatments for antibiotic resistance means that the public health risk of this phenomenon is still a major one on a global scale, regardless of the new finding.

According to CNN, an analysis published in the Lancet in 2022 estimated that antimicrobial resistance was directly responsible for the deaths of about 1.3 million people worldwide in 2019. When put side by side, that year, 860,000 people died from HIV/AIDS and 640,000 from malaria.

The CDC stated in its 2019 Antibiotic Resistance Threats Report that more than 2.8 million cases of infections resistant to antibiotics are reported annually in the United States. Over 35,000 of those individuals lose their lives.

More antibiotics have been developed to treat Gram-positive infections in the last few decades, according to Lobritz. Gram-negative bacteria are more resistant to antibiotics and generally more dangerous. “These  Gram-negative bacteria, they’ve been accumulating resistance to many of our preferred first-line antibiotics for a long time.”

“Innovations are hard to come by. It’s taken us ten years of effort on this project to get it to where it is now, and there’s still more clinical trials to go before it can be determined whether or not it’s a medicine.”

According to the researchers, the method that was used to limit the growth of Acinetobacter, blocking the creation or formation of the outer membrane, could be useful for other difficult-to-treat bacteria such as E. coli. The drug is now in phase 1 clinical trials to assess for safety in humans.