2018-11-19 10:39:13
Thanks to the Science in Parliament initiative, in which I have had the immense honor of participating, on November 6 and 7, a group of Spanish deputies, from all political groups, were presented with the most recent information on twelve related topics with science previously chosen by consensus between politicians and scientists, due to their social importance. Among these issues were some of such relevance as global warming, suicide prevention, water management or the disturbing bacterial resistance to antibiotics, a topic that I thought it appropriate to comment on here, because, in effect, the problem is very worrying.
I have spoken on several occasions in this section about this issue, since, unfortunately, it has never ceased to be topical. In fact, my first contribution to this journal, in April 2000, was entitled resistance to antibiotics (
Antibiotic resistance is therefore not a new phenomenon. Actually, it is almost as old as the pathogenic bacteria themselves, since these have been fought by other organisms using natural antibacterial substances for hundreds of millions of years. In this evolutionary battle, bacteria have evolved genes that have enabled them to resist antibiotics in various ways, such as destroying antibiotic molecules or rapidly ejecting them from their interiors before they can act, among other ingenious possibilities.
Once a bacterium has acquired a gene that makes it resistant to an antibiotic, all its offspring will also be resistant to it. Worse still, because bacteria not only transmit genes in a “vertical” way, that is, from parents to children, but they can also do it in a “horizontal” way, that is, between siblings, cousins, or even between perfect strangers. It’s as if by having a gene that allows us to have blue eyes, or to be stronger, or whatever, we can pass it on to our friends who want it. It would be fun, but above all, what would happen is that we would live in a world where there would be no private genes and all of them would be at the service of the community. This is what happens with bacteria. Once a gene has been generated by mutation that allows it to survive an antibiotic, this gene is available to other bacteria that need it.
Antibiotics are not only used to treat infections in humans, but are also widely administered to farm animals to prevent them from getting sick and thus allow them to gain weight and produce more. Spain is one of the European countries in which more antibiotics are used for this purpose. These antibiotics enter the soil and attack the bacteria that inhabit it, which can also acquire resistance genes. These genes may be transmitted to other bacteria that could be pathogenic for us. In these conditions of continuous and massive use of antibiotics, it is not surprising that bacteria resistant to several of them simultaneously do not stop increasing.
alarming data
What is the impact for our health system and the risk for us of this situation?
Today, entering a hospital for any reason is a risky situation. The risk comes not only from the cause that led us to hospital admission, but also from the fact that hospital life means that contracting an infection by a multi-resistant bacterium to antibiotics is a much more likely possibility than in ordinary life.
This risk and the loss of years of life and years of quality of life that it causes have recently been estimated in a large study sponsored by the European Center for Disease Control and published on November 5. The authors take an in-depth look at data collected for 2015 on the incidence of infections in Europe caused by sixteen types of bacteria resistant to various antibiotics, separately or in combination. Using the data on blood infections, the researchers also calculate the number of bacterial infections that did not affect the blood using a mathematical model.
The authors estimate that during 2015 alone, 671,689 infections by antibiotic-resistant bacteria occurred in Europe, of which 63.5% occurred in hospitals or health centers. These infections caused an estimated number of deaths of 33,110.
Not all of these deaths occurred at the same age and, as is normal, there were deaths of younger and older people. Furthermore, even when the infection could be defeated, days of life were lost in poor health. For this reason, the authors also estimate a parameter called THE OPENINGS, or disability-adjusted life years. This parameter values the years of life lost not only due to premature death, but also due to illness or disability.
Well, according to the data from this pioneering study, in 2015 resistant bacteria in Europe caused a loss of 874,541 years of life and years of life in good health combined. This loss of years of life and years of life in good health is similar to those lost in Europe due to tuberculosis, HOW and the flu together.
The situation is therefore very serious and the severity will continue to increase if urgent action is not taken. For this reason, it is very important that, as has been done with the Science in Parliament initiative, scientists objectively and independently inform politicians of the situation in different aspects in which science is fundamental so that, in informed manner, make the best political decisions for the benefit of citizens.
Reference:
Alessandro Cassini et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. The Lancet (2018).
More information on Jorge Laborda’s Blog.
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