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How Will We Stop the Rise of Superbugs?

A Nevada woman is dead because of an infection that was able to fend off every available antibiotic in the United States. Be afraid. Be very afraid.

It’s happening.

AMR is killing Americans.

It’s not some descendent of al-Qaida or an offshoot of ISIL. Nor is it some new disease.

It’s “antimicrobial resistance.”

And like all the trouble in the post-Cold War world coming back to haunt us, it’s a serious case of blowback.

According to the World Health Organization (WHO), AMR describes “the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and anti-malarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.”

STAT News has it all in a January 12, 2017, headline: “A Nevada Woman Dies of a Superbug Resistant to Every Available Antibiotic in the U.S.”

Writes Helen Braswell:

Public health officials from Nevada are reporting on a case of a woman who died in Reno in September from an incurable infection. Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics.

“It was tested against everything that’s available in the United States… and was not effective,” said Dr. Alexander Kallen, a medical officer in the Centers for Disease Control and Prevention’s division of healthcare quality promotion.

So-called superbugs are ascendant because of us.

“We misuse antibiotics everywhere,” noted Dame Sally Davies, Chief Medical Officer for England, in a September 23, 2016, conversation with William Karesh of the Council on Foreign Relations.

“They’re used for growth promotion and in well animals,” Davies explained. “So they’re actually substituting for good hygiene and sanitation. And as a result, infections — drug-resistant infections — are more prevalent in the States.”

Use of antibiotics in agriculture, aquaculture, ethanol production and other everyday applications “provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria,” read a study in PLoS Biology.

“Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics.”

According to STAT News’ Braswell, the Nevada woman had actually traveled extensively in India in recent years.

She broke her femur a couple years back while on the subcontinent and subsequently developed an infection for which she was hospitalized there “a number of times,” the final instance in June 2016.

In mid-August, she was hospitalized in Reno and diagnosed with an infection of Klebsiella pneumoniae, which are generally linked with urinary tract infections.

Klebsiella pneumoniae are part of more generic classification, carbapenem-resistant Enterobacteriaceae, or CRE, “bacteria that commonly live in the gut that have developed resistance to the class of antibiotics called carbapenems.”

As Braswell notes: “CDC Director Dr. Tom Frieden has called CREs ‘nightmare bacteria’ because of the danger they pose for spreading antibiotic resistance.”

That this isn’t strictly a homegrown AMR is no cause for comfort.

Dr. James Johnson, a professor of infectious diseases medicine at the University of Minnesota, tells Braswell it’s “highly improbable” that the Nevada woman is the “only person in the U.S.” similarly afflicted.

It’s likely that other Americans “are carrying similar bacteria in their guts and could become sick at some point.” Indeed, Johnson thinks “this is the harbinger of future badness to come.”

And it’s already pretty bad.

As we discussed in the October 19, 2016, issue of Wall Street Daily:

According to the Centers for Disease Control and Prevention, at least 2 million people per year in the United States become infected with bacteria resistant to antibiotics, and at least 23,000 people die as a direct result of these infections.

Worldwide, the number is more than 700,000. By 2050, we could be looking at 10 million AMR-related deaths per year.

For reference’s sake, cancer kills about 8.2 million worldwide annually.

Last October, we highlighted a handful of companies that were beginning to respond to this emerging threat, including France-based Eligo Bioscience, which is researching a CRISPR/Cas-based solution to the AMR problem.

It’s likely that other Americans “are carrying similar bacteria in their guts and could become sick at some point.” Indeed, Johnson thinks “this is the harbinger of future badness to come.”

Eligo recently won the Startup Battle at Labiotech Refresh, the premier biotech conference in the European Union.

As Clara Rodríguez Fernández writes for Labiotech, “The startup’s revolutionary approach consists in delivering CRISPR via phages to selectively kill nocive bacterial strains. These ‘sequence-specific antimicrobials discriminate the bugs at the strain level while leaving the rest of the flora completely intact.’ Since a healthy microbiome is closely linked with multiple aspects of human health, this technique could make a big change in how we fight disease.”

Seres Therapeutics Inc. (MCRB), a $400 million company based in Cambridge, Massachusetts, is developing an investigational oral microbiome therapeutic for the prevention of Clostridium difficile infection (CDI).

CDI, according to the Centers for Disease Control, is one of the top three most urgent antibiotic-resistant bacterial threats in the United States.

Meanwhile, Allergan Plc (AGN), AstraZeneca Plc (AZN), GlaxoSmithKline Plc (GSK), Johnson & Johnson (JNJ), Merck & Co. Inc. (MRK), Novartis AG (NVS), Pfizer Inc. (PFE), and Sanofi SA (SNY) have formed an alliance to plot a “roadmap to combat antimicrobial resistance.

These are major movers in a market that could swell from $11.3 million in 2015 to $433.5 million by 2025.

A little more news like that out of Nevada just might make antibiotics a lot more lucrative.

Money Quote

The ideal subject of totalitarian rule is not the convinced Nazi or the convinced communist, but people for whom the distinction between fact and fiction (i.e., the reality of experience) and the distinction between true and false (i.e., the standards of thought) no longer exist.

— Hannah Arendt, The Origins of Totalitarianism

Smart Investing,

David Dittman
Editorial Director, Wall Street Daily

David Dittman

, Contributing Writer

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