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Post Antibiotic Era Emerging Concern to Humanity Dr.T.V.Rao MD
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Post Antibiotic Era Emerging Concern to Humanity

Sep 22, 2014

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Post Antibiotic Era Emerging Concern to Humanity
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Page 1: Post Antibiotic Era Emerging Concern to Humanity

Post Antibiotic EraEmerging Concern to

HumanityDr.T.V.Rao MD

Page 2: Post Antibiotic Era Emerging Concern to Humanity

Health care Challenge of 21st Centaury

• Serious infections caused by bacteria that have become resistant to commonly used antibiotics have become a major global healthcare problem in the 21st century.

Page 3: Post Antibiotic Era Emerging Concern to Humanity

Antibiotic Resistance a Reality

• The World Health Organization says antimicrobial resistance – which includes drug-resistant bacteria, viruses, fungi and parasites – is seen in every region of the world.

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An impending threat to Humanity

• In a "post-antibiotic era", where people die from simple infections that have been treatable for decade

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Emerging of Superbugs• In recent times new

mechanisms of resistance have resulted in the simultaneous development of resistance to several antibiotic classes creating very dangerous multidrug-resistant (MDR) bacterial strains, some also known as “superbugs”

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Indiscriminate and inappropriate use of antibiotics leading cause to

Superbugs • The indiscriminate

and inappropriate use of antibiotics in outpatient clinics, hospitalized patients and in the food industry is the single largest factor leading to antibiotic resistance. In recent years

Page 7: Post Antibiotic Era Emerging Concern to Humanity

Society at Risk • The potential

negative consequences of all these events are relevant because they put society at risk for the spread of potentially serious MDR bacterial infections.

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Many other Reasons for Antibiotic Resistance

Page 9: Post Antibiotic Era Emerging Concern to Humanity

Many Reasons for Antibiotic Resistance

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WHO Releases the New Report

• The newly-released World Health Organization document finds that in every region of the world, the growing rate of antimicrobial and antibiotic resistance is a serious threat to human health. Minor infections that were once considered beaten could kill again, and lengthier stays in hospitals and higher healthcare costs are a near-guarantee.

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Resistance to UTI • Reports of resistance to

UTI medicine are particularly alarming because it has happened so quickly. When UTI medicine was first introduced in the 1980s, resistance to them was “virtually zero”; now, there are parts of the world where treatment is basically ineffective, the WHO said.

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Drug Resistance in Gonorrhoea

• When more than 1 million people are infected with gonorrhoea everyday, pause for a moment to think about the fact that treatment for the disease has failed for more than half of patients in several countries in recent years, including Canada, France, and the U.K. In 2011, gonorrhoea was the second most commonly reported infection

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Today we are losing the efficacy of Antibiotics

• “Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,”

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Key findings of the report

• The report, "Antimicrobial resistance: global report on surveillance", notes that resistance is occurring across many different infectious agents but the report focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea. The results are cause for high concern, documenting resistance to antibiotics, especially “last resort” antibiotics, in all regions of the world

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Penicillin and S.pneumoniae

• Reduced susceptibility to penicillin was detected in S.pneumoniae in all WHO regions, and exceeded 50%in some reports. The extent of the problem and its impact on patients is not completely clear because of variation in how the reduced susceptibility or resistance to penicillin is reported, and limited comparability of laboratory standards

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Klebsiella pneumoniae–Carbapenems

• Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumoniae–carbapenem antibiotics–has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients

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E. coli–Fluoroquinolones

• Resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli–fluoroquinolones–is very widespread.

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Fluoroquinolones in Salmonella and

Shigella • The resistance to fluoroquinolones among two of the major causes for bacterial diarrhoea, non typhoidal Salmonella(NTS) and Shigella species, were comparatively lower than in E.coli.

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Tuberculosis a Great Concern

• Globally, 3.6% of new TB cases and 20.2% of previously treated cases are estimated to have multidrug-resistant TB (MDR-TB), with much higher rates in Eastern Europe and central Asia. Despite recent progress in the detection and treatment of MDR-TB, the 84 000 cases of MDR-TB notified to WHO in 2012 represented only about21% of the MDR-TB cases estimated to have emerged in the world that year. Among MDR-TB patients who started treatment in 2010, only 48%(range 46%–56%across WHO regions) were cured after completion of treatment (with 25% lost to follow-up). The treatment success rate was lower among extensively drug-resistant (XDR-TB) cases.

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MDR -TB (Multidrug Resistant Tuberculosis) under reported

• Although multidrug-resistant TB is a growing concern, it is largely under-reported, compromising control efforts

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Artemisinin and Malaria

• Foci of artemisinin resistance in malaria have been identified in a few countries. Further spread, or emergence in other regions, of artemisinin-resistant strains could jeopardize important recent gains in malaria control

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Resistance to Antiretroviral Drugs • Increasing levels of transmitted anti-HIV drug resistance have been detected among patients starting antiretroviral treatment.

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Growing Resistance to Antiretroviral Therapy

• Available data suggest that 10%–17% of patients without prior ART in Australia, Europe, Japan and the United States of America (USA) are infected with virus resistant to atleast one antiretroviral drug

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Fast progressing Resistance from 1980 to

2014• In the 1980s, when

these drugs were first introduced, resistance was virtually zero. Today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

Page 26: Post Antibiotic Era Emerging Concern to Humanity

Gonorrhoea Third generation

cephalosporins• Treatment failure to the

last resort of treatment for gonorrhoea–third generation cephalosporins–has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.

Page 27: Post Antibiotic Era Emerging Concern to Humanity
Page 28: Post Antibiotic Era Emerging Concern to Humanity

MRSA (methicillin-resistant Staphylococcus aureus)

• Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of health care with lengthier stays in hospital and more intensive care required.

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Page 30: Post Antibiotic Era Emerging Concern to Humanity

Growing Resistance to Oseltamivir

• Although the frequency of oseltamivir resistance in currently circulating A(H1N1)pdm09 viruses is low(1%–2%), the emergence and rapid global spread in2007/2008 of oseltamivir resistance in the former seasonal A(H1N1) viruses has increased the need for global antiviral resistance surveillance.

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Resistance in systemic Candidiasis

• Resistance to fluconazole, a common antifungal drug, varies widely by country and species. Resistance to the newest class of antifungal agents, the echinocandins, is already emerging in some countries

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How to tackle Antibiotic Resistance

Page 33: Post Antibiotic Era Emerging Concern to Humanity

People can help tackle resistance by:

• using antibiotics only when prescribed by a doctor; completing the full prescription, even if they feel better; never sharing antibiotics with others or using leftover prescriptions.

• Follow the Prescriptions

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Health workers and pharmacists can help tackle

resistance by

• Enhancing infection prevention and control; only prescribing and dispensing antibiotics when they are truly needed; prescribing and dispensing the right antibiotic(s) to treat the illness.

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Policymakers can help tackle resistance by:

Strengthening resistance tracking and laboratory capacity; regulating and promoting appropriate use of medicines.

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Policymakers and industry can help tackle resistance by:

• Fostering innovation and research and development of new tools;promoting cooperation and information sharing among all stakeholders

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The Report on Antibiotic Resistance advises to

tackle• The report–which also

includes information on resistance to medicines for treating other infections such as HIV, malaria, tuberculosis and influenza–provides the most comprehensive picture of drug resistance to date, incorporating data from 114 countries.

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WHO South-East Asia Region

• The report’s results show high levels of E. coli resistance to third generation cephalosporins and fluoroquinolones—two important and commonly used types of antibacterial medicine–in the Region. Resistance to third generation cephalosporins in K. pneumoniae is also high and widespread. In some parts of the Region,

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Need to improve Diagnostic

Laboratories • Important actions include preventing infections from happening in the first place–through better hygiene, access to clean water, infection control in health-care facilities, and vaccination–to reduce the need for antibiotics. WHO is also calling attention to the need to develop new diagnostics, antibiotics and other tools to allow healthcare professionals to stay ahead of emerging resistance.

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MRSA a Prominent Threat

• more than one quarter of Staphylococcus aureus infections are reported to be methicillin-resistant (MRSA), meaning that treatment with standard antibiotics does not work

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The WHO’s action plan, including:

• 1 better use of vaccines;

• 2 basic hand hygiene to reduce infections, such as washing hands;

• 3 reduction of non-health uses of antimicrobial drugs;

• 4 support of research that will lead to new and better diagnostic tests;

• 5 Better surveillance, to get a better overall global antimicrobial resistance.

Page 43: Post Antibiotic Era Emerging Concern to Humanity

We need Approaches

• These approaches will include new antibiotics, but should also include studies to develop new rapid-diagnostic devices, fundamental research to understand how microbes become resistant to drugs, and how human behaviour influences the spread of resistance

Page 44: Post Antibiotic Era Emerging Concern to Humanity

We are All United to Fight Infection

Page 45: Post Antibiotic Era Emerging Concern to Humanity

We will not Forget to Wash our Hands

Page 46: Post Antibiotic Era Emerging Concern to Humanity

Visit Me for More Articles on Infection …..

Page 47: Post Antibiotic Era Emerging Concern to Humanity

• The Programme Created and Designed with Credited Information from

Articles by WHO and CDC for Benefit of Many Medical Professionals with Concerns on Reducing the Antibiotic

Resistance

• Email

[email protected]