New ‘superbug’ scare for SA

2014-05-01 00:00

A LANDMARK study by the World Health Organisation (WHO) yesterday warned that common diseases such as diarrhoea could soon mean certain death in an era of new “superbugs”.

And, the organisation said, the rise of drug-resistant bacteria and its consequences could rock the global economy if not brought under control.

KwaZulu-Natal researchers involved in the global study added their voices to the dire warnings yesterday, saying that South Africa had to rapidly develop better surveillance systems to manage drug-resistant bacteria.

These systems were needed to respond to outbreaks of bacteria which will mutate so dramatically that “superbugs” will be created and the likelihood of survival for victims would be minimal.

The study, known as the Antimicrobial Resistance (AMR) Global Report on Surveillance 2014 released yesterday, incorporated data from 129 WHO member states which focuses on antibacterial resistance.

This is WHO’s first attempt to obtain an accurate picture of the magnitude of antimicrobial resistance and the current state of surveillance globally.

“AMR is an increasingly a serious threat to global public health. AMR develops when a micro organism [bacteria, fungus, virus or parasite] no longer responds to a drug to which it was originally sensitive,” the study said.

“This means that standard treatments no longer work; infections are harder or impossible to control; the risk of the spread of infection to others is increased; illness and hospital stays are prolonged, with added economic and social costs; and the risk of death is greater — in some cases, twice that of patients who have infections caused by non-resistant bacteria,” it said.

“The problem is so serious that it threatens the achievements of modern medicine. A post-antibiotic era — in which common infections and minor injuries can kill — is a very real possibility for the 21st century,” said the report.

Professor Sabiha Essack, University of KwaZulu-Natal (UKZN) Dean of Health Sciences and a Professor in Pharmaceutical Science who jointly led the South African leg of the study, said the research has far-reaching consequences for the health profession, hospitals and public.

“There is already resistance to our current antibiotics and no new ones are being developed,” she said.

“While people with healthy immune systems shouldn’t be affected, those with compromised systems such as people living with HIV, TB, cancer, in ICU or undergoing surgery are at risk especially in hospitals.

“There has been extensive misuse of antibiotics in South Africa by both the health and agricultural fraternity.”

She said currently South Africa did not have a surveillance system such as the U.S. and UK which used nationally accessible electronic databases.

“If we had greater surveillance of the bacteria currently in circulation we could easily contain outbreaks and respond more efficiently to diseases by treating them with the correct antibiotic. In the public sector, which has access to limited antibiotics, we find high resistance to the lower number of drugs available yet in the private sector we have lower resistance to a high number of drugs available.

“The resistance being developed is something to be afraid of but we are long way from seeing a mass death scenario,” said Essack.

She urged people to use antibiotics carefully to reduce the further mutation of the drugs.

“The pharmaceutical industry is not developing new antibiotics, but rather focus on chronic medication development where the profit margins are more favourable,” said Essack.

Professor Fatima Suleman, Associate Professor in the Discipline of Pharmaceutical Sciences at UKZN who assisted Essack, said as resistance becomes more prevalent the type of antibiotics available to a patient would get stronger, more expensive and more dangerous.

“The scary thing is very little research is being done with antibiotics.

“We thought we were in a golden era with these drugs but now we urgently need research and development,” said Suleman.

Chairperson of the Durban branch of the Pharmaceutical Society of South Africa Patrick O’Donoghue said WHO’s report has highlighted an ongoing problem which pharmacists were fully aware of.

“Fortunately most doctors are informed by both the private and public laboratories in South Africa on what bacteria are prevalent during certain periods of the year and treat accordingly.

“Our concern is people using antibiotics prescribed to them for a previous infection to treat a new infection. This type of misuse breeds resistance,” said O’Donoghue.

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