The World Health Organization is warning that superbugs are now a major health threat across the globe, and experts say Canada could be doing more to track them and slow their spread in this country.
In its first global surveillance report on antimicrobial resistance, the public-health arm of the United Nations found bacteria and viruses resistant to common treatments are already entrenched in every part of the world, meaning humanity is well on its way to a “post-antibiotic era” in which everyday infections and minor injuries can kill again.
“Anti-microbrial resistance is not a future issue. It is an issue today,” Keiji Fukuda, WHO’s assistant director-general for health security, said at a news conference in Geneva. “We should anticipate to see more deaths. We should also anticipate to see higher costs, both directly but also indirectly,” Dr. Fukuda added later.
WHO said it found very high rates of drug-resistant E. coli bacteria, which causes problems including meningitis and infections of the skin, blood and kidneys. The agency noted there are many countries where treatment for the bug is useless in more than half of patients. WHO’s report also found worrying rates of resistance in other bacteria, including common causes of pneumonia and gonorrhea.
“Canada really doesn’t have a unified approach to this at all,” said Michael Gardam, the director of infection prevention and control at Toronto’s University Health Network.
“It is scary. … All of modern medicine has sort of grown up around the concept that if you get an infection we can treat it. So chemotherapy, organ transplantation, bone marrow transplantation, all of these very aggressive therapies that we give to patients for a variety of diseases, all of those increase your risk of infection and there’s always an assumption that the antibiotics will be there for you.”
Although the report did not grade countries on their ability to track antibiotic resistant infections, it did mention a Canadian program, the Canadian Integrated Program for Antimicrobial Resistance Surveillance, or CIPARS, as one of the few that tracks resistance in both humans and animals.
“I think Canada fares fairly well in the globe,” said Gregory Taylor, Canada’s deputy chief public health officer. “There’s always room for improvement and we’re working very hard to ensure our surveillance systems are the best that they can be.”
Andrew Simor, the head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre in Toronto, said he would give Canada a “B” for its ability to monitor antibiotic resistance, compared to the rest of the world.
He pointed to the Canadian Nosocomial Infection Surveillance Program, which tracks four classes of hospital-acquired infections that have grown difficult to treat with traditional antibiotics, including Clostridium difficile and methicillin-resistant Staphylococcus aureus, as an example of an already useful surveillance program that could be improved.
The program collects data from 60 hospitals, most of them large academic centres, something Dr. Simor said he would like to see expanded to more community hospitals.
“It provides the best data that we have across the country and it’s important data, but there is so much more information that we need to get that we can’t because of inadequate resources,” he said.
In 1928, Alexander Fleming’s discovery of penicillin revolutionized medicine by giving doctors the first effective treatment for a wide variety of infections. Despite the introduction of numerous other antibiotics since then, there have been no new classes of the drugs discovered for more than 30 years.