Disease-causing bacteria that resist antibiotic treatment are now widespread in every part of the world and have reached "alarming levels" in many areas, says the first global report on the issue from the World Health Organization.
"The problem is so serious that it threatens the achievements of modern medicine," says the report released Wednesday. "A post-antibiotic era – in which common infections and minor injuries can kill – is a very real possibility for the 21st century."
The report focuses on several types of bacteria responsible for common, serious diseases such as bloodstream infections, diarrhea, pneumonia, urinary tract infections and gonorrhea. Thanks in part to antibiotic overuse and the dearth of new drugs, some bugs that were once easily curable now resist even the latest, most powerful antibiotics, the report says. That's because the bugs are always evolving even when the medicines are not.
For example, cases of gonorrhea that are untreatable with the latest cephalosporins have been found in Austria, Australia, Canada, France, Japan, Norway, South Africa, Slovenia, Sweden and the United Kingdom. Urinary tract infections with E. coli bacteria that resist treatment with fluoroquinolone antibiotics make up more than half of cases in many countries, the report says.
"If no action is taken today in order to reduce the spread of antibiotic-resistant microbes and find new solutions, we may reach the point where some infections will not be treatable anymore," says Carmen Pessoa Da Silva, a Brazilian physician who leads a WHO program on the issue.
Doctors in the United States, including those at the U.S. Centers for Disease Control and Prevention, have used similarly strong words of late about so-called "superbugs" and "nightmare bacteria." They applauded WHO for sounding the alarm on a problem seen every day in U.S. hospitals and doctors' offices.
"It's scary. It's not over exaggerated," says Barbara Murray, an infectious-disease expert at the University of Texas Health Science Center, Houston, and president of the Infectious Diseases Society of America. "It's here and it's now. In hospital settings, it's bad and in some community settings, it's bad."
Steve Solomon, who directs a CDC office devoted to the issue, says: "The threat is tremendous. We are truly threatened with falling off the edge of this cliff into the post-antibiotic era. But I'm also optimistic. The commitment to address this issue is strong."
CDC already has joined government agencies around the world in what it calls a "global health security" initiative. The goals are better prevention, detection and response systems to address infectious-disease threats, including drug-resistant bugs, as they emerge anywhere in the world.
"These bacteria travel with the speed of jet travel," Solomon says.
CDC also has called for stepped-up efforts to curb inappropriate antibiotic use and for greater reliance on infection-prevention tools ranging from vaccines to safe food handling and better hand-washing in hospitals.
President Obama's proposed budget calls for $30 million a year to address the threat through new regional labs and other programs.
Murray's group also has urged Congress to pass tax credits to spur development of new antibiotics and to give the Food and Drug Administration the power to more quickly approve them.
WHO and CDC say individual patients also can play a role – by not pushing their doctors to prescribe unneeded antibiotics, finishing all antibiotic prescriptions and never sharing the medications. Misuse of the drugs can encourage the growth of drug-resistant bacteria. Another way to help: insisting health care workers wash hands and follow other infection-control measures in hospitals.