Changing policy to prevent antibiotic resistance

assorted pharmaceutical capsules and medication in different colors denoting different drugs and antibiotics

Lead investigators: Laura Piddock and Mark Webber

Introduction

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 Professor 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.

Professor 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.

In the video below, Dr Mark Webber outlines the background and impact of this research.

Changing worldwide policy on antibiotic resistance

Research objectives

Antibiotic resistance has become one of the great challenges to human health in the 21st century with increasing numbers of isolates of many pathogenic bacteria being resistant to front line, therapeutic antibiotics.

In recent years there has been an increase in the use of biocides in industrial, clinical and domestic applications. This increased usage has prompted concerns that biocide exposure may lead to biocide resistance, which as a result of common mechanisms of resistance, will also select for mutant bacteria which are cross-resistant to antibiotics.

There is a global reliance on the use of antibiotics to treat bacterial infections and the emergence of new resistant strains presents a real global health concern. Recent evidence has suggested that antibiotic resistance can be selected by exposure to biocides, which are commonly used as disinfectants and preservatives.

Research output

Using Salmonella as a model food borne pathogen, the research carried out by Professor Laura Piddock and Dr Mark Webber demonstrated that exposure to common household biocides does select for mutant bacterial strains, which demonstrate cross resistance to antibiotics. Novel mechanisms of biocide resistance were identified and the mutant strains were found not to be severely compromised in their fitness.

As a result such mutants present a credible risk of surviving in the food chain once selected and indeed are indistinguishable from antibiotic resistant isolates recovered from patients. Human infection with resistant bacterial strains is known to be associated with higher chances of mortality, morbidity and increased lengths of time in hospital, with resistant Salmonella strains being associated with a three-fold higher risk of severe illness or death than drug sensitive strains.

The work carried out by Professor Piddock and Dr Webber has had an impact on the development of European policy and has informed the drafting of new legislation governing the licensing of biocidal products across the European Union.

Research impact

The research was used by the European Commission as evidence to support two reports published in 2009 and 2010 to inform opinions as to the safety of biocide use. These reports recommended specific new research avenues be funded and that possible selection of antibiotic resistance by biocides is a valid concern and were used as part of the evidence base in preparation of a new law which has come in to force across the European Union.

Professor Piddock and Dr Webber’s research has already resulted in nine publications in internationally recognised microbiology journals and provided significant new information for policy makers and opinion leaders to formulate opinions as to the safe use of biocides and recommendations for future research priorities at a European level.

The research has not only helped to shape EU opinion but also influenced changes to the law governing the use of biocides. The new EU EU biocides regulation requires any new biocidal product to demonstrate that it does not select resistance to itself or target organisms before it can be registered and used in any formulations.

Learn more

If this has sparked an interest in studying a course in the College of Medical and Dental Sciences, you can find a list of the of Undergraduate, Postgraduate and Doctoral research opportunities on offer from the College:

For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings.

For further information about the work is also on the Antimicrobials Research Group website.

You can also read some of the publications resulting from the research:

Randall LP, Cooles SW, Coldham NG, Penuela EG, Mott AC, Woodward MJ, Piddock LJ, Webber MA. Commonly used farm disinfectants can select for mutant Salmonella enterica serovar typhimurium with decreased susceptibility to biocides and antibiotics. J. Antimicrob Chemother. 2007;60(6):1273-80. DOI 10.1093/jac/dkm359

Karatzas KA, Webber MA, Jorgensen F, Woodward MJ, Piddock LJ, Humphrey TJ. Prolonged treatment of Salmonella enterica serovar Typhimurium with commercial disinfectants selects for multiple antibiotic resistance, increased efflux and reduced invasiveness.J Antimicrob Chemother.2007;60(5):947-55. DOI: 10.1093/jac/dkm314