The antibiotic resistance apocalypse is coming

The antibiotic resistance apocalypse is coming and New Zealand is not immune with increasing superbug outbreaks giving us a taste of more to come says an infectious diseases expert, Dr Stephen McBride.

Dr McBride, the Clinical Head of Infectious Diseases at Middlemore Hospital, says germs have marched through generations of antibiotic upgrades and new drugs are failing to keep pace, threatening the very basics of modern medicine.

Speaking at the New Zealand Anaesthesia Annual Scientific Meeting in Auckland this week Dr McBride will be looking at the complexity of stopping the spread of superbugs in a hospital setting like Middlemore. “The organisation has six to seven thousand people and there may be hundreds of people in contact with affected patients over various departments during an outbreak. So a multi-faceted approach spread over many areas has to be taken for infection prevention and control.”

Dr McBride says unfortunately even then, the resistant organism can hang around. “For instance there’s a hospital overseas that reported finding a multi-resistant germ in its water systems. Despite replacing all its plumbing, it failed to eradicate the bug. Even with thousands of hours spent trying to identify how multi-drug resistant organisms infect hospital patients after an outbreak, you often can’t pull out one thing that is the problem as the organisms are now in our environment.”

Dr McBride says antibiotic resistance has become even trickier moving from the H-bug in the 50s and 60s to MRSA (methicillin-resistant staphylococcus aureus), to ESBLs (extended-spectrum beta-lactamases) in the gut, to the latest threat, CRO (carbapenem-resistant organisms) which also inhabit the gut. “We have had a lot of anti-skin infection antibiotics that have come out in the last 30 years but virtually no anti-gut organism antibiotics. If our top shelf upgraded penicillin is ineffective against CRO, we are running out of options. We have been modifying old drugs but have failed to find something completely new that the bugs haven’t had time to figure out how to deal with.”

It’s grim a picture but Dr McBride says people can do things such as washing hands to prevent the spread and, if you are a hospital patient, being empowered to question if you are concerned about infection control and cleanliness. He says busy health care workers need to see infection control as vital and at the top of competing demands for time. Lastly rational prescription of antibiotics by doctors and rational demand from patients can make a difference.

The NZ Anaesthesia Annual Scientific Meeting (ASM) is hosted jointly by the Australian and New Zealand College of Anaesthetists (ANZCA) and the New Zealand Society of Anaesthetists (NZSA).

One of Australasia's largest specialist medical colleges, ANZCA is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists, and for the standards of clinical practice, in Australia and New Zealand.

The New Zealand Society of Anaesthetists (NZSA) represents and champions the professional interests of anaesthetists and the optimal care of their patients through advocacy, promoting education, and supporting anaesthesia networks throughout the country.

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