Long-treatable everyday medical conditions such as urinary tract and bloodstream infections could once again become killers if antibiotic resistance continues at its current rate, the World Health Organisation has warned.
The unprecedented WHO study, published yesterday and compiled using data from 114 countries – including China – described the problem of antibiotic resistance as a “global emergency”.
In China, treatment for Escherichia coli – the most frequent cause of bloodstream and urinary tract infections – using antibiotics is now ineffective in as many as 70 per cent of patients, the 256-page report by the global health watchdog said.
Already, methicillin, the drug used to combat Staphylococcus aureus – a common cause of skin infections, respiratory disease and food poisoning – does not work in more than one-third of Chinese patients.
Video: Bacterial resistance to antibiotics
More than half of patients in China have resistance to the common antibacterial medication for treatment of Klebsiella pneumoniae, a common cause of hospital-acquired urinary tract, bloodstream and respiratory tract infections. Resistance to the treatment of last resort for these infections – carbapenem antibiotics – already stands at 8 per cent on the mainland.
The hard-hitting report presents in stark detail the magnitude of the threat.
“Without urgent, co-ordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” warned Keiji Fukuda, the WHO’S assistant director general for health security, adding that implications of the resistance trend would be “devastating”.
Though the exact health burden of resistance to antibacterial drugs is not known, another WHO report released last December estimated that hospital-acquired infections with multiresistant bacteria cause about 80,000 deaths annually in China, at least 25,000 across the European Union and at least 23,000 in the United States.
Mortality aside, health care costs could rise due to more expensive drugs, extended rounds of medication and longer hospital stays. Patients could experience more side effects due to more toxic drugs required.
“The problem is perhaps more serious than many people realise,” says Dr Vivian Lin, director of the division of health sector development for the WHO’s Western Pacific Region, which includes 37 countries including China. “We are looking at resistance to treatment of last resort for some life-threatening infections having spread to all regions in the world.”
The other key finding of the report is the significant gaps in surveillance among countries and regions and a lack of standards for methodology, data sharing and co-ordination, says Dr Seto Wing-hong, a Hong Kong-based member of the WHO’s Global Strategic and Technical Advisory Group on antimicrobial resistance. Some countries had incomplete data; many others had none at all.
“If you have no good data, you’re groping in the dark – and that’s pointless,” said Seto.
The report kick-starts a global effort led by the WHO to address drug resistance, which will involve the development of tools and standards and improved collaboration worldwide to track drug resistance, measure its health and economic impacts and design targeted solutions.
Overall, the prevalence of antimicrobial resistance on the mainland was relatively high compared to other countries, said Seto. A key reason for this, he said, had been the high usage of antibiotics.
An important cause of “irrational use of antibiotics” on the mainland is the financial compensation provided to health care institutions for drug sales, according to Zhejiang University researchers in their study published in the journal PLOS Medicine in November last year.
With less than 20 per cent of a hospital’s expenditure coming from government contributions, the institutions sell their services and drugs to finance their budgets. Drug sales constitute about half of institutional income and most of the profit, with more than 25 per cent being sales of antimicrobial agents.
Meanwhile, in the sectors of animal husbandry and farming, the overuse of antimicrobial agents has contributed to the occurrence and spread of antibiotic-resistant microbes in the environment.