If resistance destroys the ability to treat infection the whole edifice of modern medicine crumbles
The Health Protection Agency (HPA) welcomed actions to raise the profile of emerging drug resistance and fully supported the focus of World Health Day 2011, which looked at the increasing need for the development of new antibiotics to combat this ever-growing trend in drug resistance.
‘I am delighted that resistance is the focus of the WHO's 2011 World Health Day,’ said Dr David Livermore, director of the HPA's antibiotic resistance monitoring and reference laboratory. ‘So much of modern medicine - from gut surgery to cancer treatment, to transplants - depends on our ability to treat infection. If resistance destroys that ability then the whole edifice of modern medicine crumbles.
‘It's vital to grasp that fighting the emergence of resistance is fighting evolution itself. To keep ahead it is vital that we conserve what antibiotics we have - using them carefully and prudently - and that pharmaceutical companies and regulators support the development and licensing of new antibiotics.’
The HPA conducts monitoring and surveillance of antibiotic resistance in the UK and has done so since the late 1980s. The Agency also evaluates new antibiotics under development.
Alongside scientists at Cardiff University, it recently co-authored a paper published in The Lancet Infectious Diseases looking specifically at the emergence of NDM-1 and its import to the UK. This is an enzyme that destroys carbapenems; an important group of antibiotics used for difficult infections in hospitals.
The HPA has so far recorded 88 cases of bacteria with NDM-1 in the UK, most of them from patients linked to the Indian subcontinent (as well as 283 isolates with 'KPC' (Klebsiella pneumoniae carbapenemase), another type of carbapenem resistance).
Further work from this collaboration shows that NDM-1 is widespread outside the hospital environment in Delhi, circulating in bacteria than inhabit drains and tap water. The results of the study concur with findings of the Health Committee of the Municipal Corporation of Delhi showing sewage contamination of tap water in the city.
Improvements in infrastructure to stop the circulation of resistant bacteria in sewage are needed to assist in infection control and prevent further spread of antibiotic resistance.
Christine McCartney, executive director of the HPA's microbiology services, said: ‘The emergence of antibiotic resistance especially against carbapenems, is a major public health concern. Antibiotic resistance makes infections much harder to treat and its spread underscores the need for good infection control in hospitals both in the UK and overseas, and highlights the need for new antibiotics to be developed.’