As experts sound the alarm over rising antibiotic resistance, which, according to The Lancet, was directly responsible for 1.3m deaths in 2019, the Medical Research Council is to launch the local leg of a global study in five hospitals to assess the situation in South Africa, reports Medical Brief.
The group of global scientists involved in The Lancet study said that antibiotic-resistant bacteria are multiplying at recurring mass gathering events, and annual deaths from antimicrobial resistance are expected to rise to 10m by 2050.
In South Africa, the non-profit Global Antibiotic Research and Development Partnership (GARDP) and the South African Medical Research Council (SAMRC) have launched an observational study will collect and analyse data in 150 patients being treated for infections caused by carbapenem-resistant organisms across five institutions in South Africa.
The study will start this month at Livingstone Hospital in Gqeberha, followed by Groote Schuur in Cape Town, Chris Hani Baragwanath in Soweto, King Edward VIII in Durban and Cape Town’s Tygerberg Hospital.
“We are seeing rising rates of resistance to carbapenems – the class of antibiotics most commonly used to treat hospital-acquired multidrug-resistant bacterial infections,” said François Franceschi, GARDP’s project lead for serious bacterial infections. “This is a global health emergency requiring urgent action. We hope this study will give us some of the answers we need to provide better treatments for people who develop these antibiotic-resistant infections in the future.”
The study will look at the epidemiology as well as the treatments administered to both adults and children with severe infections caused by carbapenem-resistant Enterobacterales and/or Pseudomonas aeruginosa (CREP).
It will also collect data on the clinical outcomes for patients with confirmed CREP infections in the five hospital sites.
“There is very limited data from African countries on the demographics, risk factors and clinical outcomes of hospital patients affected by carbapenem-resistant infections. The Serious Bacterial Infections – SBI-CREP study will provide fundamental information that could ultimately be used to improve treatments, and work towards reducing deaths and illness associated with these infections.
“Through a central microbiology laboratory, the study will also provide much-needed data on the molecular epidemiology of the bacterial isolates responsible for CREP infections”, said Adrian Brink, clinical investigator for the study at Groote Schuur Hospital.
The study will also look into the capabilities of the hospitals involved in the study to carry out clinical trials with an ultimate goal of building capacity in the region. This type of support could pave the way for future interventional trials, which will generate high quality data to assess the effectiveness of novel therapeutics to fight carbapenem-resistant infections.
The study will continue into 2023 in South Africa and will be extended to six hospital sites in India in early 2023.
A recent study published in The Lancet showed that nearly 1.3m people – and potentially millions more – died as a direct cause of antibiotic resistant infections in 2019. The study reported that sub-Saharan Africa had the highest death rate from antibiotic-resistant infections in the world. Hospital-acquired infections are among the deadliest of these resistant infections, which urgently require new and improved treatments.
And in England, statistics show that nearly 150 serious infections that did not respond to antibiotics occurred every day last year, according to new data, with the UK Health Security Agency (UKHSA) showing the average of 148 severe antibiotic-resistant infections per day were up by 2.2% on the previous pandemic year (53 985, up
from 52 842).
However, reports The Independent, overall infection numbers were still down on pre-pandemic levels, with UKHSA saying this was driven by things such as reduced social mixing and extra handwashing.
The use of antibiotics – which help fuel antimicrobial resistance (AMR) – also fell by 15% between 2017 to 2021.
Professor Susan Hopkins, chief medical adviser at the UKHSA, said: “We are already seeing resistance emerge to our very newest antibiotics – innovation to find new treatments will only succeed if we use what we have responsibly. Overuse of antibiotics will mean they stop working against life-threatening conditions such as sepsis.”
UKHSA analysis shows that resistance to some key antibiotics remains high.
It said more than two fifths of E. coli bloodstream infections are resistant to co-amoxiclav, a key antibiotic used in the treatment of serious infections in hospital.
UKHSA is also monitoring signs of resistance to newer antibiotics such as cefiderocol.
Professor Dame Jenny Harries, chief executive of the UKHSA, said: “Antibiotic resistance is not a distant problem that we can ignore. Infections caused by antibiotic-resistant bacteria are killing thousands of people every year in this country and globally, as well as having a huge economic impact.
The group of global scientists involved in The Lancet study said that antibiotic-resistant bacteria are multiplying at recurring mass gathering events, and annual deaths from antimicrobial resistance are expected to rise to 10m by 2050.
They write that unknown factors continue to increase this puzzling condition at a global scale and that further scientific work is needed to identify these and help combat the issue.
Study details
Globalisation of antibiotic-resistant bacteria at recurring mass gathering events
Avinash Sharma, Alfonso J Rodriguez-Morales, Tieble Traore, Shuja Shafi, Sherif A El-Kafrawi, Esam I Azhar, et al.
Published in The Lancet on 16 November 2022
Antimicrobial resistance is associated with an estimated 4·95m deaths annually and is currently a leading cause of death worldwide.
Despite numerous global initiatives to control the surge of antimicrobial resistance, at the current rate of increase, annual deaths from antimicrobial resistance are estimated to rise to 10 million by 2050. This puzzling conundrum indicates that there are unknown factors that continue to increase antimicrobial resistance at a global scale and that identifying them will be crucial in controlling the ongoing antimicrobial resistance pandemic. There are also scarce data about the geographical distribution and evolution of antimicrobial resistance over time in settings outside of health-care facilities, and more accurate scientific evidence is required to promote optimal policies to combat antimicrobial resistance.
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