In a world awash in antibiotics, dangerous infections are getting even harder to fight.
The problem? Bacteria are outsmarting the drugs meant to wipe them out at a faster pace than new antibiotics can be discovered and produced.
To address the growing crisis of antibiotic resistance, global health officials on Monday listed a dozen antibiotic-resistant "priority pathogens" that pose the greatest threats to human health.
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The first-of-its-kind list is meant to steer public and private research dollars toward developing new antibiotics for these particular families of bacteria, the World Health Organization (WHO) said. The announcement is also designed to push public agencies to support more research by pharmaceutical companies, which currently lack financial incentives to develop new drugs aimed at rare, but deadly, superbugs.
"Governments and industry must work very closely on this if we are to find new weapons to fight growing antimicrobial resistance," Marie-Paule Kieny, WHO's assistant director-general for health systems and innovation, said Monday on a call with reporters.
"It's very important to start now, as quickly as possible, in order to have in three, five, 10 years, the antibiotics that we need," she said.
Drug-resistant bacteria infect millions of people around the world, though experts on the press call said it's difficult to know precisely how many people are affected each year, or how many infections result in death.
In simple terms, the main cause of this scary trend is that we've been taking too many antibiotics and using them widely to grow livestock for food in mainly developed countries.
Doctors might prescribe the pills — or patients demand them — to treat illnesses that aren't actually bacterial infections. The enormous use of antibiotics in the livestock industry is also spreading drug-resistant bacteria through our food supply.
The list focuses on "gram-negative bacteria" that are resistant to multiple antibiotics and can pass on genetic material to other bacteria, allowing those to develop drug resistance as well.
Gram-negative bugs most frequently affect a person's intestinal tract, which can lead to severe and life-threatening bloodstream infections and pneumonia — particularly among elderly people in nursing homes and hospitals. The bacteria can also contaminate medical equipment, such as blood catheters and ventilators.
"This has been a major challenge for modern medicine," Kieny said. "These bacteria are really spreading very frequently in health care facilities."
They're also far more difficult and expensive to study compared to "gram-positive bacteria," which tend to affect the nose and skin of a healthy individual.
That's why private pharmaceutical companies and public health agencies have tended to invest more time and money in developing solutions for gram-positive bacteria, Nicola Magrini, a WHO scientist for innovation, access and use of essential medicines, said.
He said the WHO researchers hoped to send a "strong message" to the public health and pharmaceutical communities that more investment is needed for these 12 priority pathogens.
The WHO list is divided into three categories based on the urgency of need for new antibiotics.
WHO's "priority pathogens" list
Priority 1: Critical
1. Acinetobacter baumannii, carbapenem-resistant
2. Pseudomonas aeruginosa, carbapenem-resistant
3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: High
4. Enterococcus faecium, vancomycin-resistant
5. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
6. Helicobacter pylori, clarithromycin-resistant
7. Campylobacter spp., fluoroquinolone-resistant
8. Salmonellae, fluoroquinolone-resistant
9. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: Medium
10. Streptococcus pneumoniae, penicillin-non-susceptible
11. Haemophilus influenzae, ampicillin-resistant
12. Shigella spp., fluoroquinolone-resistant
Bacteria in the "critical" group include multi-drug resistant bacteria that can withstand the use of antibiotics known as carbapenems, as well as third-generation cephalosporins. These are currently the antibiotics of last resort.
The "high" and "medium" priority bacteria include other increasingly drug-resistant bacteria that cause more common diseases, including gonorrhea and food poisoning caused by salmonella.
WHO developed its list together with the division of infectious diseases at the University of Tübingen in Germany.
"New antibiotics targeting this priority list of pathogens will help to reduce deaths due to resistant infections around the world," Evelina Tacconelli, a professor at the University of Tübingen who helped develop the list, said in a press release.
"Waiting any longer will cause further public health problems and dramatically impact on patient care," she said.
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