Where antibiotic resistance is worst around the world wired

Where Antibiotic Resistance Is Worst Around the World | WIRED

SARAH ZHANG

SCIENCE

09.17.15

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WHERE ANTIBIOTIC RESISTANCE IS WORST AROUND THE WORLD

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INSTEAD OF THE

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usual doom and gloom about

antibiotic resistance, let’s begin with the good

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news. A new global report on antibiotic use, released yesterday, actually found a drop in Staph bacteria resistant to the antibiotic methicillin in countries seriously tackling drug resistance—places across Europe, the US, Canada, and South Africa. The boring stuff like handwashing and antibiotic stewardship? It works.

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That’s the good news. The bad news is, well, everything else. The report from the Center for 22

Disease Dynamics, Economics & Policy, a public health research organization, shows worrying rates of resistance to last-line antibiotics—the ones given when all others have failed —especially in developing countries. As people use antibiotics more and more often, bacteria develop resistance to the drugs. “It’s a growing problem in the developing world,” says Ramanan Laxminarayan, director of CDDEP. “It’s going to get a lot worse before it gets better.”

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CDDEP has spent the past several years hunting down data in these developing countries, often by going to private lab networks. “This is data you can get from places that are hidden, but once you unlock it, it provides a very valuable public policy perspective,” says Laxminarayan.

CDDEP’s interactive ResistanceMap now contains data on drug resistance from 39

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countries and consumption from 69—obviously still incomplete, but more complete than previous collections. The World Health

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Organization’s big antimicrobial resistance report last year, for example, largely left off India, where national data isn’t available.

CDDEP

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CDDEP

And India is a hotbed for antibiotic resistance.

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According to data from the private lab network SRL in India, Klebsiella pneumonia resistance to carbapenems, an antibiotic of last resort, was 57 percent—compared to just below 5 percent

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across Europe. (CDC director Thomas Frieden has called carbapenem-resistant microbes “nightmare bacteria.”)

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And the proliferation of carbapanem-resistant bugs isn’t a huge outlier, either. Resistance to other antibiotics in bacteria like E. coli is also high, in some cases over 80 percent. “India has a perfect storm,” says Laxminarayan, including high background rates of infectious disease plus a large pharmaceutical industry plus an increasingly affluent population that can afford antibiotics. “You put all the things together and it’s this gigantic petri dish of experimentation that is resulting in highly pathogenic strains.”

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Change in resistance of Staph bacteria to three different antibiotics.

Oxicillin resistance represents MRSA. CDDEP

The solution to growing antibiotic resistance is as unsexy as they come. CDDEP doesn’t believe inventing new antibiotics alone can help—they’re expensive and they only perpetuate the cycle of bacteria developing resistance to every new drug. Rather, hospitals,

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public health officials, and doctors have to save the effective antibiotics for when they’re really

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needed.

That means vaccines and clean water to keep people from getting sick in the first place, not giving antibiotics for colds willy nilly, and cutting down on antibiotic use in animals. No magic bullet—just many small, incremental changes. It’s a boring solution, but the drop in methicillin-resistant in high-income countries shows these changes do add up, slowly but surely.

#ANTIBIOTIC RESISTANCE #GLOBAL HEALTH #HEALTH #INFECTIOUS DISEASES #SCIENCE

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