Superbug death may mean dawn of post-antibiotic era


green and white antibiotics

Australians are still using more antibiotics than international peers, as experts warn a post-antibiotic era may be arriving

The death of an American woman from an untreatable infection with a gram-negative bacterium resistant to all classes of antibiotics has left Australian infectious diseases experts “deeply alarmed”.

According to an editorial published in the Medical Journal of Australia, the woman had broken her femur while travelling in India; the injury was complicated by osteomyelitis.

She was hospitalised and given intravenous antibiotic treatment, and after returning to the US in mid-2016 was admitted to hospital with systemic inflammatory response syndrome.

Pan-resistant Klebsiella pneumoniae was isolated from a tissue specimen, and the woman died of untreatable septic shock.

Professor Cheryl Jones, President of the Australasian Society for Infectious Diseases (ASID), along with co-authors wrote that the woman’s death “may herald a post-antibiotic era in which high-level antimicrobial resistance (AMR) is widespread, meaning that common pathogens will be untreatable”.

“Should this be the case, it would profoundly affect all areas of health care, and society,” they wrote.

“Simple childhood infections would once again be life-threatening events, major surgery would be associated with high mortality, chemotherapy for cancer and organ transplantation would no longer be possible.”

The Federal Government has been proactive in its response to AMR with the formation of the Australian AMR Prevention and Containment Steering Group, followed by the release of the first National AMR strategy in June 2015.

However, the authors say the challenge is to translate the plan into a roadmap to life-saving action.

“The per capita consumption of antibiotics by people in Australia is among the highest in the world. Australian prescribers and consumers need to reduce antibiotic use in both humans and animals,” she wrote.

“To have an impact on AMR, we will need to address all its drivers in Australia in humans, animals and agriculture.

“These are not only unrestrained use of antibiotics but poor infection control, the decline of antibiotic and diagnostic research and development, and the introduction of AMR into Australia through international travel or from ingestion of imported food products that may contain AMR organisms (eg, seafood and meat), particularly if antibiotics were employed during their production.

“We also need to better define the impact of AMR through coordinated national surveillance and communicate the impact of AMR infections to our community.

“A list of tangible actions against each of the drivers of AMR, coordinated across human and animal health and agriculture, must be an urgent priority. The ASID, the Australian Society for Antimicrobials, and animal health societies will host government representatives and stakeholders in June 2017 at the second Australian AMR Summit in Melbourne, with the aim of drafting this action list.”

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