Global threat of antibiotic resistance must be resisted, say Canadian experts

And it's not just patients and doctors who are to blame: decades of widespread use of antibiotics to promote the health of farm animals to our tables and environmental contamination by ubiquitous drugs have led to so-called super bacteria such as MRSA and VRE that have developed resistance to their effects.

But all of this underlies the fact that antimicrobial resistance is a natural phenomenon, a process of bacterial evolution that has been occurring for millennia, said Gerry Wright, director of the Institute for Research on Infectious Diseases of the McMaster University.

"What's frustrating, of course, is that our excessive use of antibiotics when we do not need them contributes to this selection," he told Hamilton. "If we create a situation in which we use antibiotics when we should not, then we create selective pressures that increase the chances of the bacteria becoming resistant organisms.

"And that's the problem we're seeing right now: there are more and more bacteria in the clinic where we use a lot of antibiotics that do not respond to all the medications we have available to us."

The problem is that the pharmaceutical industry is not investing more time or money in researching new antibiotics, Wright said, explaining that science is not only "very difficult" but that any drug discovery is excessively expensive.

Drug manufacturers are not ready to incur an average expenditure of $ 1 billion to develop an antibiotic capable of curing an infection in five to ten days, when they can use their medications to treat conditions such as hypercholesterolemia or blood pressure, which are usually taken for life.

Add to that the fact that a new antibiotic may have a limited shelf life because the insects it is supposed to treat can develop resistance and that there is little incentive, said Dr. Andrew Morris, director of the Sinai System's antimicrobial management program and the University Health Network. in Toronto.

Morris said the shortage of new antibiotics is also a problem for civil society, as people take for granted that these drugs have been widely available since the 1940s.

"So we can have an anti-cancer drug that can extend the life of six months and cost between $ 5,000 and $ 100,000," he said. "On the other hand, we can have an antibiotic that will fully save someone's life and we in the arms if this drug costs more than $ 1,000. "

A national online survey of Canadians' knowledge of the issue found that 60% of respondents incorrectly thought that antibiotic resistance meant that an infected person was resistant to drugs. Published as part of the Global Week for Antibiotic Resistance, which ends Sunday, the Leger poll of more than 1,500 Canadians aged 18 and over also found that 44% rate resistance as a greater concern for countries. in development.

"Antimicrobial resistance affects everyone around the world, including Canada, where it is a growing concern," Morris said. "It's really a global health problem that deserves collective action."

According to recent projections from the Organization for Economic Co-operation and Development (OECD), which represent countries like Canada, Australia, the number of drug-resistant infections is expected to result in about 2.4 million more deaths in developed countries alone. the United States and the United Kingdom

Other experts warned that at that time, the annual death toll from antibiotic resistance would rise to 10 million worldwide – minimal cancer – and would cost the economy global $ 100 trillion.

"The worst thing that can happen is that we'll end up as before in the 1920s-1930s" before the discovery of penicillin, when more people died from an infection than from any other cause, Wright said.

"Five years ago, in Canadian hospitals, people would die without being infected," said Wright.

"It's not necessarily thousands of people. People do not fall dead in the street. There is no zombie apocalypse, "he said.

"But we have people in our hospitals that we have not been able to treat."

And it is not only the already infected people who could be affected by the resistance, he said. "It will come back to a time when you can not do an organ transplant because you will be immunocompromised for the rest of your life. You will not be able to save premature babies, treat leukemia.

"The things we consider absolutely routine today will disappear or, if they are not, incredibly risky."

Wright and Morris both stress that concerted action must be taken now to stem the tide of resistance. This means that the federal and provincial governments take a leading role in coordinating innovative programs to encourage antibiotic development, find alternative treatments, and limit abuse and overuse.

"We are really at this perfect storm level and that is filtering all Canadians – currently, not all Canadians are affected – but ordinary Canadians are increasingly affected now, and the situation will worsen further. in addition, "said Morris.

Unless the world war or the emergence of a catastrophic virus is manifested, "I think the biggest threat to health care in the world is antimicrobial resistance."