Changing worldwide policy on antibiotic resistance

Antibiotic resistance is one of the greatest challenges to human health in the 21st century, with a global reliance on use of antibiotics to treat bacterial infections threatened by the emergence of new resistant strains. Research from Prof Laura Piddock, Dr Mark Webber and others at the University of Birmingham demonstrated that biocides – commonly used as disinfectants and preservatives – are a key factor in increasing antibiotic resistance of pathogenic bacteria.

This evidence has been used by the European Commission to underpin new legislation now in force across the EU. Parallel research from the University has also shown that use of certain antibiotics in veterinary medicine can increase resistance in particular bacteria strains which then present potential risks to human health, leading to amendment of international policy on the use of antibiotics in food producing animals through the WHO and FDA. Prof Piddock also launched the ‘Antibiotic Action’ campaign – a global initiative designed to inform and educate politicians, policy makers and the public all about the need for discovery, research and development of new antibiotics as well as appropriate use.
 
More information:
http://www.birmingham.ac.uk/mdsresearch

Duration: 4.02mins

Speaker

Dr Mark Webber, Senior Research Fellow, College of Medical and Dental Sciences

Transcript

Antibiotic resistant bacteria is one of the biggest threats to human health around the world today. This is a problem that’s been getting worse and worse for years and we now have bacterial isolates  that have been found from patients that are resistant to most of the antibiotics that we would use to treat them.   This is a problem in the developing world but also in countries such as the UK.  Antibiotics underpin all of modern medicine and without antibiotics you wouldn’t be able to do the complicated surgeries, hip replacements, you wouldn’t be able to treat cancer patients effectively, so if we lose the ability to use antibiotics to treat bacterial infections, it compromises all of modern medicine. 

I’m just going to briefly talk about two case studies of some of the work into antibiotic resistance we’ve done here at Birmingham.  Now both of these studies relate to understanding how and when bacteria can become resistant to antibiotics. As our ability to treat resistant infections are becoming more difficult due to resistance, we need to try and prevent resistance from occurring in the first place. The first of these studies was led by Professor Laura [0:00:59]. Laura’s been a major researcher into resistance at Birmingham for a long time. Now what Laura did was show that the use of antibiotics in animals can select for resistant bugs in the animals that are then passed into the food chain and can cause infections in humans that are then difficult to treat because they’re resistant to those specific drugs.  Now her work proved the molecular mechanisms by which the bacteria could become resistant to the antibiotic were the same in the human isolates and those in the animals and she showed the selective conditions under which this occurred.

The second case study is one that I led where we showed that if you expose bacteria to biocides – now these are common products that we use in hospitals, farms and in the home increasingly and are often known as disinfectants – that bacteria respond to the stress from the biocide in the same way that they do to when you expose them to an antibiotic, as in their ability to resist the action of the drug is the same. So if you expose a bacteria to a biocide it can become antibiotic resistant.

Both the case studies I’ve mentioned briefly already have been used as evidence by law-makers to change laws. So the case study that Laura led which I spoke about, showing that the use of antibiotics in animals can select for resistant bugs in the food chain, was use by the Food & Drug Administration in America and they actually banned the use of those antibiotics in animals to prevent the selection of resistance from recurring.  Similarly the work that I led on biocides has been used by the European Union and they have changed the European wide law about how biocides are registered and now it’s a requirement for any new biocide to be registered, that it should show that it does not select for antibiotic resistant bacteria. So both of these case studies have shown that we can have impact from our basic science and this basic science has turned into changes in laws which have affected millions of people around the world. The fight is far from over. Resistance is a massive problem. Resistant pathogens are evident and they are in hospitals and they are in the community all around the world. So the UK Chief Medical Officer suggested that antibiotic resistance should be considered to be as serious as terrorism. It’s on the WHO’s Global Risk Register, it’s one of the biggest threats to human health going forward.

So going forward what we need to do is understand more and more about how bacteria become resistant to antibiotics and the key things they need to do to survive and cause infection – survive in hospitals and cause infection in the host – and this gives us the opportunity to identify new weak points in their biology that we can exploit to develop new therapies. We have a lack of new antibiotics. There may be some that will be developed in the next 10, 20 years but it’s a very expensive and very time-consuming business.  What we do need to do though is to be creative in the way that we think and that the research that we’re doing at Birmingham is able to be used and translated into new therapies to try and prevent resistant bugs from being able to survive, to cause damage, to be passed from host to host.

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