Superbugs could kill 10 million a year if we keep using antibiotics incorrectly

If superbugs continue to spread we will no longer be able to treat infection effectively, making certain types of surgery and cancer treatments almost impossible to perform safely

The sun reflected on the beach at Inchydoney, Co Cork. The EPA-funded PIER project will help us understand whether we can pick up superbugs from using our seas, lakes and rivers for recreation. Picture: Denis Minihane

Did you know that Covid-19 is not the only public health emergency we are currently dealing with in Ireland?

A particular type of antibiotic-resistant bacteria called Carbapenemase-Producing Enterobacteriaceae, CPE for short, were declared a public health emergency in Ireland in October 2017.

That’s the superbug recently reported in Cork University Hospital. It can harmlessly colonise a healthy person’s gut but it can have serious consequences if it gets into the blood or urine and it poses particular risk to vulnerable people.

Antibiotic resistance happens when bacteria mutate and block the very drugs we have used for decades to treat the infections they cause.

Today is the European Antibiotic Awareness Day #EAAD ! Whether you are a #HealthCare professional, a patient, an #AnimalHealth professional, a #Farmer or a pet owner we need to play together to #KeepAntibioticsWorking 💊. The ball is in our court, let’s not drop it! pic.twitter.com/cgYqDmSmfR

— EFSA (@EFSA_EU) November 18, 2020

Often called “superbugs” these bacteria are so concerning because some of them are resistant to almost all of the antibiotics we have available.

We have been using these life-saving drugs to successfully defeat infection caused by bacteria since the end of World War II. They were a revolution for medicine.

Now we are facing the very real threat of going back to a pre-antibiotic era.

If these superbugs continue to spread we will no longer be able to treat infection effectively. And if we cannot, certain types of surgery and cancer treatments will become almost impossible to perform safely.

This is not an issue facing us in the distant future, this is a very real problem now.

The first report of a death due to an untreatable infection emerged from the US in 2017. A woman was admitted to hospital in Nevada on August 18, 2016, with a serious wound infection. She developed septic shock and unfortunately died within weeks.

Analysis of the organism causing the infection revealed it was resistant to almost all available antibiotics and all treatment efforts failed.

Whilst reports such as these are still relatively rare, it is essential we take action now to prevent an increase in such occurrences.

If we don’t, it is estimated that by 2050, 10 million deaths per year will be due to antibiotic-resistant infections.

Today is European Antibiotic Awareness Day and marks the beginning of World Antibiotic Awareness Week.

Did you know?💊

Up to 5⃣0⃣% of all antimicrobial use in European hospitals may be unnecessary or inappropriate, which might lead to #AntimicrobialResistance.

Today’s #EAAD reminds us how important it is to #KeepAntibioticsWorking.

More: https://t.co/M0FzMGkdx8 pic.twitter.com/Zkf2PA9NvD

— EU One Health (@EU_Health) November 18, 2020

It should be a reminder of how much the discovery of antibiotics has helped us all to live longer and healthier lives - and how much is at stake if we do not act now.

We all have a role to play in making sure antibiotics are used in the right way to secure their use for our children and grandchildren:

• Only use antibiotics when we need them. They are powerless against viruses. Taking an antibiotic for a cold or flu will not treat it but could potentially have serious side effects.
• Prescribed antibiotics should be taken correctly - complete the dose as directed and do not share them.
• Take unused antibiotics back to the pharmacy for correct disposal. Don’t put them in the bin or flush them down the toilet.

It is important to realise that antibiotics are not only used to treat infection in humans but they are also widely used in veterinary medicine, agriculture and food production.

The global One Health concept recognises that the health of humans, animals and our shared environment are all interconnected.

Antibiotic resistance is possibly the best example of a One Health challenge, which cannot be tackled in isolation. In order to deal with it we must bring together the human health, animal health and environment sectors.

What can be done to reduce the use of #antibiotics in animals?

👉Reduce the use of #antimicrobials.
👉Replace them with alternative treatments.
👉Reduce the #livestock production system.

On the ball? Let's not drop it! https://t.co/uscE3vhKxx#EAAD #KeepAntibioticsWorking

— EFSA (@EFSA_EU) November 18, 2020

The Government through the National Action Plan on Antimicrobial Resistance and first One Health report on Antimicrobial Resistance and Antimicrobial Use in Humans and Animals recognises this.

In addition to this, the Environmental Protection Agency and Health Service Executive fund our AREST (Antimicrobial Resistance and the Environment) project. It is helping us better understand what role the environment is playing in spreading antibiotic resistance.

Covid-19 restrictions have seen us all engaging with nature more, getting out for walks and swimming in the sea.

The AREST project has already detected superbugs in recreational waters. Now our work on the EPA-funded PIER project will help us understand whether we can pick up superbugs from using our seas, lakes and rivers for recreation.

This is important research but we also need to empower the next generation to be antibiotic guardians.

Our team at NUI Galway has developed secretlifeofmicrobes.com – a new hub of information, videos, resources, games and experiments to help educate school children about this great challenge for humanity and medicine.

Young people are leading the charge for action on sustainability and climate and they can also play a major role in safeguarding antibiotics for all of us.

What we need to remember now is that the more bacteria are exposed to antibiotics, the quicker they “learn” how to become resistant.

Now society needs to react faster. Antibiotics are fantastic drugs that have changed our lives for the better. 

It is not just up to the doctors, vets, scientists and politicians. It is essential we all work together to safeguard antibiotics for future generations. The time for action is now.

• Dearbháile Morris is Professor of Antimicrobial Resistance and One Health at NUI Galway. She is Head of the Discipline of Bacteriology at the School of Medicine. She established the Antimicrobial Resistance and Microbial Ecology Group in 2010 and is Director of the Ryan Institute Centre for One Health.