ESOF2014: Antibiotic Resistance: A Ticking Time Bomb?

(July 23rd, 2014) Our weapons against pathogenic bacteria are becoming increasingly blunt. It’s time to talk openly about how to avert this threat to human health. During the ESOF conference, Anne Glover, Henrik Wegener and Birgitta Normark shared their opinions and ideas.

It is no secret anymore: antibiotic resistance is a serious threat to public health worldwide. Each year, resistant bacteria kill 25,000 people in the EU and no new antibiotic class has been discovered since 1987. Hence, there’s a desperate need to find new anti-bacterial drugs. Otherwise, we risk having no cure even for minor infections already in 20 years. Even worse, all modern medicine heavily depends on antibiotics. Without them, organ transplantation, cancer chemotherapy, hip replacement or even care of preterm babies would be close to impossible.

To discuss this pressing health issue, top experts in the field got together with politicians and journalists at the EuroScience Open Forum 2014 in Copenhagen. They shared different opinions and knowledge, and came up with ways to solve the problem. The consensus: Only joined forces can stop the time bomb ticking.

Anne Glover, molecular and cell biologist at the University of Aberdeen and Chief Scientific Adviser to the President of the European Commission, was special guest at this session. She posed a very provocative question: “Do you want to die by carelessness?” She was referring to the careless use and prescription of antibiotics (some countries sell antibiotics OTC): “When you go to the doctor and say you needed antibiotics, they will probably give you some; because from the doctor’s point of view, there are no side effects. The side effects for you as a patient might be quite small but the side effects for all of us could be quite large.” Glover also had an explanation for the lack of novel antibiotics. “Some of our policy inadvertently is preventing the development of new antibiotics. The regulation says that no new antibiotic can be used before we used every other antibiotic as a treatment. So, where is the incentive for a company to invent a new antibiotic, when it cannot sell it?", she pointed out and suggested to offer pharmaceutical companies, investigating antibiotics, more profit. While all these arguments sounded like straight from a politician’s mouth, Glover also told us her researcher’s point of view: “We do need to think about new alternatives to antibiotics, like bacteriophages or viruses to attack the infecting bacteria.”

Henrik Caspar Wegener from the Technical University of Denmark added another important and not to be neglected point. Wegener is Adjunct Professor of zoonoses epidemiology and head of the World Health Organization Collaborating Centre on Antimicrobial Resistance in Foodborne Pathogens. “The antibiotics that we use in animals are exactly the same as we use in humans, and they cause exactly the same resistance. But they are given routinely in the feed and in the water to healthy animals, often simply for growth promotion, and not to manage disease,” he said. He went on to tell us what’s the root of the problem. And it’s not hard to guess: financial interests. Farmers want to produce more animals and veterinarians (and pharmaceutical companies) want to sell more antibiotics. His suggestion is simple: “In my eyes, there is only one way to cope with this: Regulation. So, each individual gets its own fair share of the common good.”

A study published in 2007 revealed a strikingly uneven distribution of this common good. Dutch farmers, for instance, used ten times more antibiotics than their Norwegian peers to produce the same amount of meat. The raw numbers are even scarier: they used 200 mg of antibiotics per kilogramme meat. When this data were published, the Dutch government immediately responded with new rules and it worked. On the other hand, one might argue that only a limited number of bacteria spread from animals to humans. But Wegener explains: “Unfortunately, tracking this transmission is very difficult because either bacteria adapt to the new human host or human bacteria catch resistance genes from their animal bacteria colleagues.”

Pathogenic or resistant bacteria not only spread locally but also globally, thanks to peoples’ ever-increasing desire to travel. This is the field of expertise of Birgitta Henriques Normark, who’s head physician at the Swedish Institute for Communicable Diseases and studies antibiotic resistance and host-microbe interactions in bacterial infections. During the ESOF session, she addressed the global spread of antibiotic resistance and its consequences and explained the selection of resistant bacteria by antibiotics and the transfer of resistance genes between bacteria. She also spoke about successful clones: “These are bacteria that are genetically very closely related, have approximately the same kind of factors that promote the spread and are found in different parts of the world. We think that some factors within the bacteria are important for how successful they are.” If scientists could target these factors, new vaccines and treatments would be just around the corner. But research still needs more time. Thus, it’s important, Normark said, to prevent the spread of resistant bacteria by better hygiene, infection control and vaccination. What does Normark wish for the future of antibiotics research? “What I would like to have is new antibiotic classes, not only development of the old ones. And hopefully something, we do not get resistance development on.”

So, the take-home-message for all journalists and session attendees: We need new anti-bacterial treatment options, be it antibiotics, viruses or bacteriophages. And, if we do not handle it carefully, every new development will soon become useless again.

Karin Lauschke

Picture:, Henrik C. Wegener, Birgitta H. Normark, Anne Glover, Conference (Karin Lauschke)

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