Having an 8 year old, I can honestly say that when I think of a super villain I think of Rhino, The Goblin, Mystique, Magneto, Cat Woman, The Joker, Loki – you know the villains that super heroes like Spiderman, Batman, the Avengers or The X-Men fight against. If you’re a bug fighter, you might think differently, especially after the WHO released their list of the 12 most dangerous superbugs.
Similar to the list of Top Emerging Pathogens that were released by WHO prior to Christmas, the WHO has released a list of superbugs we need to be on the lookout for. The 12 bacteria listed were chosen based on their level of drug resistance, the number of deaths they cause, the frequency they infect people outside of healthcare facilities and the burden they place on healthcare facilities. The top 3 offenders, while not as common as other antibiotic resistant organisms (AROs), are incredibly costly to manage and have very high mortality rates. The top 3 offenders include Carbapenem-resistant Acinetobacter baumannii, Carbapenem-resistant Pseudomonas aeruginosa and Carbapenem-resistant and ESBL-producing Enterobacteriaceae. These bacteria are most commonly associated with medical devices such as ventilators, catheters and endoscopes.
In the “we need new antibiotics to treat” group the WHO identified Vancomycin-resistant Enterococcus faecium (VRE), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-intermediate Staphylococcus aureus, Vancomycin-resistance Staphylococcus aureus, Clarithromycin-resistant Helicobacter pylori, Fluoroquinolone-resistant Campylobacter spp., Fluoroquinolone-resistant Salmonellae, Cephalosporin-resistant Neisseria gonorrhoeae and Fluoroquinolone-resistant Neisseria gonorrhoeae. This group of bacteria are ones that cause infections in healthy people. According to the CDC, Gonorrhoeae is the 2nd most commonly reported infectious disease with approx. 820,000 new infections reported each year and the majority of those are between 15 and 29 years old with 20 – 24 year olds being the age group with the highest numbers.
The last group include Penicillin-non-susceptible Streptococcus pneumoniae, ampicillin-resistant Haemophilus influenzae and Fluoroquinolone-resistant Shigella spp. The concern here is that this group is becoming increasingly resistant to available drugs. If we do not start to become more vigilant, the group will creep up higher on the list of priority, particularly if new treatments are not developed.
While our treatment options are limited and certainly concerning if drug companies do not start working on the development of new options, the upside is that science continues to show that antibiotic resistant pathogens are not more resistant to disinfectants than antibiotic sensitive pathogens. While we may not have treatment options, ensuring that we have a strong infection prevention program that includes a focus on hand hygiene, effective cleaning, and disinfection of environmental surfaces and medical devices, we can minimize the transmission. The concern of course still exists from a perspective of transmission outside of healthcare facilities, where cleaning and disinfection and/or hand hygiene practices are not as strict.