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In only what can be described as one of the Medical field’s worst nightmares, WHO published on Monday a list of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health.

The main reason a list being published was so that it can guide and promote research and development (R&D) of new antibiotics, that can combat the ever growing global resistance to antimicrobial medicines.

Key Features of the List: (Full Detailed List Below)

The WHO list is divided into three categories according to the urgency of need for new antibiotics: critical, high and medium priority.

The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.

The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhoea and food poisoning caused by salmonella.

What about Tuberculosis?

Tuberculosis – whose resistance to traditional treatment has been growing in recent years – was not included in the list because it is targeted by other, dedicated programmes. Other bacteria that were not included, such as streptococcus A and B and chlamydia, have low levels of resistance to existing treatments and do not currently pose a significant public health threat.

Objective of the List:

The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics. These bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.

“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.” says Dr Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation.

WHO priority pathogens list for R&D of new antibiotics

Priority 1: CRITICAL

  • Acinetobacter baumannii, carbapenem-resistant
  • Pseudomonas aeruginosa, carbapenem-resistant
  • Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: HIGH
  • Enterococcus faecium, vancomycin-resistant
  • Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
  • Helicobacter pylori, clarithromycin-resistant
  • Campylobacter spp., fluoroquinolone-resistant
  • Salmonellae, fluoroquinolone-resistant
  • Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: MEDIUM
  • Streptococcus pneumoniae, penicillin-non-susceptible
  • Haemophilus influenzae, ampicillin-resistant
  • Shigella spp., fluoroquinolone-resistant

What Next?

This list seems to serve as a wake up call, calling in for reinforcements in terms of pushing Pharmaceutical giants to up the R&D process. We are fast running out of options and the scene looks bleak at this rate.

Why this huge gap in demand and supply you may wonder, this is mostly because drugmakers have been hesitant to invest in antibiotics because they don’t offer much in terms of financial gains. Unlike treatments for chronic diseases, people only use antibiotics for short periods of time. And the recent bouts of awareness to control the use of the antibiotics, have not been attracting enough interest from the pharmaceutical industries.

To combat this, and in bids to encourage research and development, experts have been calling for a global innovation fund to fill in the gaps left by industry and support research on antibiotic resistance and its solutions.

However in the end, while more R&D is vital, alone, it cannot solve the problem. To address resistance, there must also be better prevention of infections and appropriate use of existing antibiotics in humans and animals, as well as rational use of any new antibiotics that are developed in future.

Here’s hoping that this elicits the right response and we can win this seemingly uphill battle against these superbugs!

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