A future without infection cures?

The Chief Medical Officer (CMO), Professor Dame Sally Davies, has described antibiotic resistance as ‘one of the greatest threats to modern health’, warning that the public faces “a future without cures for infection” if antibiotics are not used responsibly. Published earlier this year (March 2013), the CMO annual report1 reminded the health service that, without suitable antibiotics to treat infection, minor surgery and routine operations could become high risk procedures in the future. The CMO further stated that there needs to be a move away from the current limited focus on MRSA and C. difficile to a wider focus on infection control and antimicrobial resistance. New challenges are emerging, such as those around Enterobacteriaceae (E. coli), and Klebsiella related species, which are now the most frequent agents of hospitalacquired infection. E. coli alone accounts for around 36% of bacteraemias, compared to MRSA, which now accounts for only 1.6%. Of particular concern is the suggestion that mortality in patients due to multi-resistant E. coli, is approximately 30%, compared with 15% for those with antibiotic susceptible E. coli. Prof. Davies went on to outline 17 recommendations, which included:

• Better surveillance of data across the NHS and worldwide to monitor the developing situation.
• More work carried out between the healthcare and pharmaceutical industries to preserve existing drugs and encourage the development of new antibiotics.
• Better hygiene measures when treating the next generation of healthcareassociated infections, such as new strains of harder to treat Klebsiella.

War on antimicrobial resistance