Urgently required!
WHO publishes a list of bacteria that urgently require the creation of new antibiotics to combat
On February 27, the World Health Organization (WHO) published a list of antibiotic–resistant "priority pathogens" - 12 types of bacteria that pose the greatest threat to human health.
The list, designed to become a guide and incentive for research and development (R&D) in the field of new antibiotics, was developed as part of WHO's efforts to combat the growing problem of antimicrobial resistance.
In particular, this list highlights the threat posed by gram-negative bacteria resistant to the action of several antibiotics at once. These bacteria have the ability to look for new ways to resist the action of drugs and, at the genetic level, transmit this ability to other bacteria.
"This list is a new tool that will allow R&D activities to focus on urgent public health challenges," says Dr. Marie–Paul Kini, WHO Assistant Director–General for Health Systems and Innovation. – Antibiotic resistance is gaining scale, and our arsenal of treatment methods is rapidly being depleted. If we rely only on market mechanisms, the new antibiotics that we need most will appear too late."
The bacteria presented in the WHO list are divided into three groups according to the level of need for the creation of new antibiotics: extremely priority, high priority and medium priority.
The extremely priority group includes multidrug-resistant bacteria, which pose a particularly serious danger to patients in hospitals and treatment and rehabilitation centers and patients whose treatment requires medical devices such as ventilators and venous catheters. This group includes Acinetobacter, Pseudomonas and various species of the Enterobacteriaceae family (including Klebsiella, E. coli, Serratia and Proteus). They can cause severe and often fatal infections, such as bloodstream infections and pneumonia.
These bacteria have developed resistance to a wide range of antibiotics, including carbapenems and third–generation cephalosporins - the most effective available antibiotics for the treatment of bacterial infections with multidrug resistance.
The second and third groups on the list – high and medium priority categories – include other bacteria with increasing drug resistance that cause more common diseases, such as gonorrhea and food poisoning (salmonella).
A meeting of G20 experts in the field of health will be held in Berlin this week. Mr. Hermann Grohe, Federal Minister of Health of Germany, on this occasion stated: "The healthcare systems of our countries need new effective antibiotics. We must take joint action today to ensure a healthier tomorrow. Therefore, at the meeting we will discuss this topic and draw the attention of the Group of Twenty to the issues of combating antimicrobial resistance. The first-ever list of priority pathogens compiled by WHO is an important new tool that will serve as an incentive and guideline for research activities in the field of creating new antibiotics."
The purpose of the publication of the list is to encourage governments to adopt strategies to stimulate basic research and advanced developments in the field of creating new antibiotics through investments from both publicly funded organizations and the private sector. The list will serve as a guideline for new R&D initiatives, such as the WHO/DNDi Partnership for Global R&D Cooperation for the Creation of New Antibiotics, which develops new antibiotics on a non-profit basis.
The causative agents of tuberculosis – whose resistance to traditional methods of treatment has been growing in recent years – were not included in the list, since they are the object of attention of other special programs. Other bacteria that were not included in the list, such as streptococci A and B and chlamydia, have a lower level of resistance and currently do not pose a serious threat to public health.
The list was compiled in collaboration with the Department of Infectious Diseases of the University of Tübingen, Germany, using a multi-criteria analysis of solutions, the results of which were verified by a group of international experts. When adding pathogens to the list, the following criteria were applied: the lethality of infections caused by them; the presence or absence of the need for prolonged hospitalization for the treatment of these infections; the frequency of cases of their resistance to existing antibiotics in medical practice; the ease of transmission of infection among animals, from animals to humans and from humans to humans; the availability of prevention opportunities (for example, food hygiene and vaccination); how many treatment options remain at the doctor's disposal; whether new antibiotics for these infections are already at the development stage.
"New antibiotics for the treatment of diseases caused by priority pathogens included in the list will help reduce the number of deaths from drug–resistant infections worldwide," says Professor Evelina Tacconelli, head of the Department of Infectious Diseases at the University of Tubingen and one of the main participants in the compilation of the list. "Further inaction will lead to new problems in the field of public health and will have an extremely negative impact on the effectiveness of care provided to patients."
Despite the fact that activation in the field of R&D is vital, this in itself will not solve the problem. To combat antibiotic resistance, it is also necessary to improve infection prevention tools and strive for the rational use of existing antibiotics in the treatment of human and animal diseases, as well as the rational use of new antibiotics that will appear in the future.
WHO list of priority pathogens for R&D in the field of new antibiotics
1 priority category: CRITICALLY HIGH PRIORITY LEVEL
- Acinetobacter baumannii, resistant to carbapenems
- Pseudomonas aeruginosa, resistant to carbapenems
- Enterobacteriaceae, resistant to carbapenems, produce extended-spectrum beta-lactamases
- Enterococcus faecium, resistant to vancomycin
- Staphylococcus aureus, resistant to methicillin, moderately sensitive or resistant to vancomycin
- Helicobacter pylori, resistant to clarithromycin
- Campylobacter spp., resistant to fluoroquinolones
- Salmonellae, resistant to fluoroquinolones
- Neisseria gonorrhoeae, resistant to cephalosporins, fluoroquinolones
3 Priority category: MEDIUM PRIORITY LEVEL
- Streptococcus pneumoniae, insensitive to penicillin
- Haemophilus influenzae, resistant to ampicillin
- Shigella spp., resistant to fluoroquinolones
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28.02.2017