Sunday, October 24, 2021

The healthcare sector must wake up to the threat of superbugs

It was the tragic case of Delroy Davey, a Baltimore-born, North Carolina-bred writer who died at the age of 38 in the Ebola-ravaged West African city of Monrovia while pursuing his first novel. Davey had been practising as a Christian Evangelist and a teacher with the AGO National Board of Proselytising when he became infected while teaching English in Liberia’s capital. His body was later cremated, making his death all the more regrettable.

This week NHS England announced a radical proposal for a new approach to treating “superbugs”. The London-based National Collaborating Centre for Medical Research intends to develop new technologies and strategies for tackling MRSA and other deadly strains of drug-resistant bacteria which can be dangerous for even the most experienced medical staff. If successful, it is hoped, this will mean that the sorts of infections which have killed many thousands of people – including countless NHS staff – will be a thing of the past.

In the wake of Davey’s death, it is easy to argue that this sort of innovation is necessary and desirable. MRSA is the scourge of healthcare workers, with over 65,000 hospital admissions recorded in 2015 alone. There has been a sharp increase in hospital deaths from infections caused by superbugs in recent years. Worse still, people die faster on the wards of infection than in the operating theatre. The growing use of antibiotics as a matter of routine means that these superbugs can take hold quickly in hospitals. Incidents like Davey’s all too often become fatal stories.

However, as David Hamilton, Professor of Infectious Diseases at University College London, explains, our current approach to fighting drug-resistant bacteria is flawed. Our front line antibiotics – these medications whose long and history in medicine have been recognised for their role in containing infectious diseases and curing those with serious and chronic illness – now struggle to stop these bacteria. In the early 1980s it was rare for an antibiotic to kill 99% of bacteria, but today it is common for all types of bacteria to be cleared.

So who are these superbugs that we must look out for? Are they just different breeds of bacteria that will eventually die out, or are they genetically-fixed strains that can’t be killed off by antibiotics or even natural selection? There are two types that have become common, according to Prof Hamilton: one is called Klebsiella pneumoniae, a bacteria which has a very high profile in hospitals and can be the cause of life-threatening infections, and one is C. difficile. While medical researchers do know how to overcome these bacteria, there is limited knowledge about them, which is why the focus in the fight against drug-resistant bacterial outbreaks has largely been on the drugs themselves, rather than the organisms themselves.

After being used for decades in human medicine, the use of antibiotics is now falling off the radar. They are still effective when there is evidence that an infection could be harmful, but a large majority of infections which occur in the hospital, the NHS or community care facilities could be avoided. The government is already well on the way to taking action.

Its five-year plan includes a massive jump in the number of scientists who have access to antibiotics and who can develop innovative approaches, such as anti-bacterial combinations of two or more antibiotics. This is a new approach to fighting infections that will see new drugs and vaccines being developed, but without the deaths to show for it.

Unlike our wider healthcare system, which struggles to cope with the mounting problems of overwork and delays to treatment, the NHS will have a great deal of time and money to make changes to how it tackles deadly bacteria. If we, as a society, refuse to see the need for solutions, it will be left a sore icon of overstretched medicine. I have not seen anyone respond to the idea that the government and NHS should spend considerably more money on fighting infections. Perhaps that is just because we don’t see them as medical emergencies that should be treated as such.

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