20 Mar Expert views on Antibiotic Resistance
Expert commentary by University of Otago Professor of Biochemistry Kurt Krause on the World Health Organization’s list of the most important antibiotic-resistant bacterial pathogens:
“The World Health Organization has done a good job in compiling this global list, which includes all of the resistant organisms prominently featured in media and medical reports, plus a few extra that may be a little less well-known.
“Topping the list are Acinetobacter, Pseudomonas and Enterobacteriaceae. “These three Priority 1 targets include many strains that are carbapenam resistant, and carbapenam is a very powerful antibiotic often reserved for the most serious infections. They also include a few strains that are effectively resistant to all antibiotics and almost untreatable.
“Priority 2 targets include six organisms such as Enterococcus, Staphylococcus aureus, Campylobacter and Neisseria gonorrhoeae, the last being the cause of a common form of sexually transmitted infection.
“The first two are included for resistance to vancomycin and methicillin respectively and the last two for fluoroquinolone resistance. Recently particular strains of N. gonorrhoeae have become resistant to multiple drugs raising the spectre of untreatable STI.
“Finally, the Priority 3 list includes Streptococcus pneumoniae, Haemophilus and Shigella. These are two primarily respiratory pathogens and one intestinal pathogen.
“From a New Zealand perspective, the most important members on this list would include Campylobacter, Streptococcus pneumoniae and Staphylococcus aureus.
“Campylobacter, an important cause of gastrointestinal disease, continues to dominant the list of New Zealand reportable diseases, with a rate of about 150 cases per 100,000 population. However, some clinicians feel this is an underestimate, with as many as 1 per cent of New Zealanders having this illness yearly.
“Significant numbers of Streptococcus pneumoniae and Staphylococcus aureus infections also occur annually in New Zealand.
“Each year about 100,000 people here are hospitalised with infection as the primary cause, and this represents about 10 per cent of all hospitalisations. More than 60 per cent of these infections are bacterial in nature, when the cause can be determined. This suggests that controlling bacterial disease is an important goal in New Zealand.