Authors: Martha Powell, Future Science Group
The WHO has this week published a report detailing the antibiotic-resistant bacteria that pose the greatest health risk and should be the focus for new antibiotics. It is hoped the list of “priority pathogens”, which includes 12 families of bacteria, will guide and promote research and development efforts into novel treatments.
“This list is a new tool to ensure research and development responds to urgent public health needs,” commented Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation, “Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”
The report was chaired by Evelina Tacconelli, from the University of Tübingen (Germany), and utilized a multi-criteria decision analysis technique to identify the priority bacteria. Evidence and surveillance data from all WHO regions were included, as were existing databases from current guidelines on healthcare-acquired infections.
The final list categorizes bacteria into three groups based on the urgency of need for new treatments. The most critical, ‘urgent’ group includes bacteria that pose a significant threat in healthcare settings, for example Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae. All of these bacteria are resistant to multiple antibiotics, including carbapenems and third generation cephalosporins; in addition, these pathogens are responsible for severe and often fatal infections.
The other tiers, termed ‘high’ and ‘medium’ priority, include more common infections such as methicillin-resistant Staphylococcus aureus, Salmonella and Neisseria gonorrhoeae. The notable exception from the list is Mycobacterium tuberculosis; however, the WHO states this disease has not been included as they believe it is already being efficiently targeted by dedicated programs.
The report is aimed at pharmaceutical companies, research institutions and policy-makers across the globe, and hopes to promote research and development of new antibiotics. The list is part of broader initiative by the WHO to tackle growing antimicrobial resistance across the world.
Tacconelli stated: “Antibiotic-resistant infections have a major impact on patients’ quality of life and are associated with high death rates.
“Modern medicine relies on antibiotics to treat infections and to prevent them in high-risk patients. This includes transplant recipients or those affected by cancer, as well as in patients receiving common procedures such hip-replacements and Caesarean sections. However, the current pipeline of antibiotics is almost empty.
“This report marks a major step forward in identifying which bacteria pose the greatest risk for patient care because of a lack of effective treatments. We hope that it will drive governments and research groups working in antibiotic development to set the right research priorities that will reduce the burden of antibiotic-resistant infections globally.”
The WHO has stressed that, although an increase in research and development efforts is vital, it can’t solve the issue of resistance alone. In order to address rising antibiotic resistance there must also be better prevention strategies in place and antibiotics must be utilized appropriately in both animals and humans. However, this report appears to demonstrate a step forwards in the fight against resistant infections.
Update: In light of some concerns around the omission of tuberculosis from the newly published list the WHO has released an additional statement reaffirming the critical need for the research and development of new antibiotics for this disease.
Kieny explained: “Mycobacterium tuberculosis, the bacterium responsible for human TB, was not included in the scope of the prioritization exercise as the intention was to identify previously unrecognised health threats due to increasing antibiotic resistance. There is already consensus that TB is a top priority for R&D for new antibiotics.”