People will die, warns antibiotic expert

In at least 3 countries (Italy, Greece and Malta) the resistance to last-line antibiotics has become an “endemic problem”, meaning their hospitals are unable to treat patients infected with resistant bacteria.

The alarming discovery in China of a gene that makes infectious bacteria highly resistant to antibiotics has sparked fears of an epidemic.

Besides E. coli they include the pneumonia bug Klebsiella pneumoniae and Pseudomonas aeruginosa, which can trigger serious lung, blood and surgical infections. And two-thirds of farm animals generally – including cattle, sheep, pigs, turkeys and chickens – have ampicillin-resistant E.coli, according to a PHE report.

This suggests “the progression from extensive drug resistance to pandrug resistance is inevitable”, they said.

This prompted the researchers to collect bacteria samples from pigs at slaughter across four provinces, and from pork and chicken sold in 30 open markets and 27 supermarkets across Guangzhou between 2011 and 2014. They also found it in 16 E coli and K pneumoniae samples taken from 1,322 patients.

Worryingly, the gene can be transferred between strains of bacteria and was found in both humans and animals.

Lead researcher Professor Jian-Hua Liu, from the South China Agricultural University in Guangzhou, said: ‘These are extremely worrying results. The polymyxins were the last class of antibiotics in which resistance was incapable of spreading from cell to cell.

In particular, the scientists behind the study identified antibiotic-resistant DNA strands that were being transferred between Klesbsiella pneumoniae, which causes pneumonia, and Escherichia coli (better known as E. Coli), a leading cause of urinary tract infections.

The researchers say the lower infection rate among humans is proof they weren’t the first ones to cultivate the resistance.

The researchers suggest in their paper that “it is likely that MCR-1-mediated colistin resistance originated in animals and subsequently spread to people”. “Although now confined to China, mcr-1 is likely to emulate other resistance genes such as blaNDM-1 and spread worldwide”, the researchers said.

The polymyxins are an older class of antibiotic, discovered more than 60 years ago but relatively little used due to their toxicity. China’s agriculture ministry has already responded to the report by launching a risk assessment on the use of colistin in animal feed additives. Chinese and British experts came to the alarming conclusion that our last line of antibiotic defense has been breached.

A high prevalence of the resistance gene was found in E. coli bugs isolated from animals and raw meat samples.

He pointed out that China’s pig farming industry is the largest in the world, more than twice the size of Europe’s. The use of generic antimicrobial drugs in animals is not normally under veterinary control in China.

Laura Piddock, a professor of microbiology at the University of Birmingham, said that the use of polymyxins had to be minimized “as soon as possible” and described the discovery as “worrying”.

Until now, rare cases of resistance occurred only through mutation in individual organisms, severely limiting transmission. It remains to be seen how quickly the gene may spread more widely-but given that antibiotic resistance already kills thousands of people every year, it’s bad news however fast it happens.