The problem of resistance to diseases is not new, but the WHO has tried for the first time, put numbers. Therefore, it has asked the 194 countries that are members of the organization to send the most recent data they have. And there has emerged the first problem: only 114 had information about any of the seven bacteria on which they were asked, and there is nothing worse than treating a problem is not knowing how severe. There are many, and it is clear conclusion: the most resistant forms – what medicine could define as the worst – are already worldwide.
The example may be the bacteria resistant to carbapenems, one of the last families of existing antibiotics Klebsiella pneumoniae. These superbugs (pathologists do not like the name, but the media tend to quickly simplify such complicated names) were detected just over 10 years ago in U.S. ICUs. Its spread has been unstoppable. The report of the WHO, 80 countries have reported cases. And in proportions that are not negligible. By focusing on the WHO European region, 68.2 % of people infected with klebsiella in Greece already had this resistance; in Georgia, the percentage is 57.1 %. In Spain, fortunately, the rate at 0.3%, although there are hospitals in Madrid, among others, have reported outbreaks that fail to eradicate months. Therefore, the Community of Madrid has launched a specific plan to try their regulation. Fortunately for the general population, this bacterium is typical of hospital systems, and does not usually appear on the outside. But for those affected, yet few, is a major problem as they cause infections for which almost no alternatives. Often severe in people already weakened and appear pneumonia (as the name suggests) and sepsis or systemic infections. Also, are easily transmitted, indicating the WHO.
The seven groups of bacteria – resistance selected by WHO for this first global study could be considered “sentinel pathogens,” says Rafael Canton, vice president of the Spanish Society of Infectious Diseases and Microbiology (SEIMC). ” They could have chosen other, but it is clear that these are everywhere,” he says.
Specifically, apart from pneumoniae resistant to carbapenems Klebsiella, has asked resistant to cephalosporins klebsiellas, Escherichia coli resistant to cephalosporins and fluoroquinolones, Staphylococcus aureus resistant to methicillin (the famous MERS), and within bacteria that are not specific to hospital environment, resistant to penicillin pneumonic streptococcal, salmonella and fluoroquinolone -resistant Shigella and Neisseria gonorrhea resitente to cephalosporin. As shown, a combo can worry the least apprehensive.
As an addition, the report presents four other infections which resistance is also a problem: tuberculosis (3.6% of cases that do not respond to standard treatment, a percentage that rises to 20.2 % among those who have already gone through above); HIV (between 10% and 17% of those newly infected with virus insensitive to any of the antivirals); malaria (with pockets of resistance to artemisinin, the standard medication) and influenza (with variants, such as the so-called A, who no longer respond to one of the two families of existing drugs).
Localized disease, is sufficient to infect the digestive, urinary tract, respiratory support systems, blood, lungs and any superficial wound system. And of cause, death or prolonged hospital stays shorten healthy life years measure – favorite – WHO: 440,000 in only attributable to gonorrhea planet and many more to diarrhea of Escherichia coli and salmonella.
Canton diagnosis agrees: ” We could run out of options,” he says. It would be as if the world gave a jump – back – in time and return to the old days of antibiotics. “The danger is that we can reach a preantibióticos situation,” says the doctor. “Today not a transplant or surgery without prophylaxis be understood; are key to modern medicine. “
This situation, however, has not yet occurred. For sufferers of these variants ” drug combinations are chosen,” says Canton. ” Or is resorted to classic antibiotics with a safety profile not so good.” There are other measures that can be taken, as extreme care in handling patients (especially the most serious ICU) ” with multidisciplinary programs.”
The doctor gives an example of the plans to combat these infections work: “In the eighties, 40% or 45 % of staphylococci in Spain were MRSA; Now, according to the WHO report, is 22.5 %. “
But the concern is there. If the further stretch resistance, will only be able to fight with new antibiotics. ” But there is new and coming few,” says Canton.
While the drugs come to our help, the doctor seems right that WHO launched an alert message. “You have to change social norms as happened to snuff ” so that people know how to use these medicines better, he says. Let people know that the “misuse of antibiotics has a side effect: the resistance.” Fleming, 90 years ago, I would put it another way: ” That man is not so ignorant.”