Antimicrobial resistance (AMR) poses a significant threat to the health of all humankind, with potentially devastating economic consequences. In 2015, the World Health Organization (WHO) established the Global Antimicrobial Resistance and Use Surveillance System (GLASS) to monitor AMR in common bacteria and invasive fungi, and antimicrobial consumption (AMC) in humans. Recently, the 2022 GLASS report was launched, the conclusions of which are worrisome.
According to data, gathered in 2020 from 87 countries, 50% of resistance cases were reported in bacteria frequently causing bloodstream infections in hospitals, like Klebsiella pneumoniae and Acinetobacter spp. Commonly used antibiotics are ineffective against these often fatal infections. Thus, patients require last-resort antibiotics, such as carbapenems. However, there is a little fraction of bloodstream infections, 8%, caused by Klebsiella pneumoniae that do not respond to the drug, making them unmanageable. «These are indeed bad news», states Roberto Díez, CEO of Telum Therapeutics.
Moreover, antibiotic resistance is spreading amongst common bacterial infections. For instance, 60% of Neisseria gonorrhoea isolates, the microbe responsible for the sexually transmitted gonorrhea, are resistant to the commonly used oral antibiotic ciprofloxacin. Another warning signal: over 20% of Escherichia coli isolates can evade first-line antibiotics ampicillin and trimoxazole, as well as second-line drugs fluoroquinolones.
«There is an urgent need to develop new antimicrobial drugs, since antibiotic resistance puts millions of people at risk», points Díez. «In 2001, Vincent A. Fischetti and his team described the in vivo use of bacteriophage enzymes, known as endolysins, as potential therapeutics. Endolysins are responsible for cleaving bacteria cell wall at the end of the phages’ lytic cycle, allowing the release of new viruses. This leads to the death of the bacteria. But what is even more interesting is that the lysis process can also occur from the outside, if endolysins are administered as a drug». Telum Therapeutics is devoted to engineering lysins to enhance their antimicrobial properties and kill bacteria from without.
The GLASS 2022 report also warns of the need to collect more data to identify the reasons why, after a few years of being stable, antibiotic-resistant infections are on the rise. The authors point to the increase of antibiotic treatments due to COVID-19 pandemic as one of the multiple causes. They also state that insufficient testing coverage and weak laboratory capacity in most low- and middle-income countries difficult interpreting antibiotic resistance
rates. By the next phase of the GLASS project, WHO aims to overcome this critical gap by strengthening the capacity to monitor and provide quality data from all countries.
Article of reference
Global antimicrobial resistance and use surveillance system (GLASS) report 2022. Geneva: World Health Organization; 2022.