In March 2013, the U.S. Centers for Disease Control and Prevention described emerging antibiotic resistance as a “very serious problem” and a “nightmare.” At about the same time, government officials in the United Kingdom called antibiotic resistance a “catastrophic threat” and “national security risk as serious as bioterrorism.” They weren’t talking about methicillin-resistant Staphylococcus aureus (MRSA) or drug-resistant tuberculosis (though still pernicious problems), but rather drug-resistant Gram-negative bacteria.
Dr. Herbert Schweizer, a Professor in the Department of Microbiology, Immunology and Pathology, is an internationally recognized expert in antibiotic resistance of Gram-negative bacteria, has published widely in this area, and serves as a consultant to pharmaceutical companies. He recently returned from a grant review panel of the European Union Innovative Medicines Initiative in Brussels, Belgium, where he served as the only academic scientist from the United States.
“As U.S. health authorities and the public were pre-occupied with MRSA, the first member of the carbapenem- resistant enterobacteriaceae (CRE) family emerged in the United States and rapidly spread throughout the nation and then worldwide, receiving little fanfare at the time,” said Dr. Schweizer, whose laboratory studies mechanisms of antibiotic resistance and tests novel antibiotic candidates for the pharmaceutical industry.
“Dr Schweizer’s laboratory also provides unique bacterial strains and other tools for drug discovery efforts that are frequently licensed to industry through CSU Ventures,” said Rodman Tompkins, Director, Licensing and Business Development for CSU Ventures, the technology transfer office for Colorado State University, noting the importance of collaborative efforts in advancing drug discovery.
This is the third time Dr. Schweizer’s expertise was sought by the IMI in the evaluation of the “No Drugs for Bad Bugs” program. The European Union is investing 2 billion euros in this private-public partnership aimed at identifying novel ways of discovering and developing new antibiotics to fight emerging antibiotic resistance mostly in Gram-negative bacteria. Dr. Schweizer noted that similar efforts are needed in the United State where, in 2009, the Infectious Diseases Society of America warned of “bad bugs, no drugs” and of a domestic public health crisis in the making in face of stagnating antibiotic discovery efforts and emergence of antimicrobial resistance, especially with the aptly named ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species).
CRE infections have become increasingly resistant to last-resort antibiotics during the past decade, and more hospitalized patients are getting lethal infections that, in some cases, are impossible to cure. CRE bacteria kill up to half of patients who get bloodstream infections from them. In addition to spreading among patients, often on the hands of health care personnel, CRE bacteria can transfer their resistance to other bacteria within their family. Currently, almost all CRE infections occur in people receiving significant medical care in hospitals, long-term acute care facilities, or nursing homes.
These findings were published in March in the Centers for Disease Control and Prevention’s Vital Signs report, and are a call to action for the entire health care community to work urgently – individually, regionally and nationally – to protect patients. During just the first half of 2012, almost 200 hospitals and long-term acute care facilities treated at least one patient infected with these bacteria.
“CRE are nightmare bacteria. Our strongest antibiotics don’t work and patients are left with potentially untreatable infections,” said CDC Director Tom Frieden, MD/ MPH. “Doctors, hospital leaders, and public health, must work together now to implement CDC’s ‘detect and protect’ strategy and stop these infections from spreading.”
In addition to CRE bacteria, researchers are concerned other once-treatable, Gram-negative bacterial infections are becoming antibiotic resistant. In 2011, Dr. Schweizer said, scientists discovered a "superbug" strain of gonorrhea in Japan that is resistant to all recommended antibiotics. Even in North America, the treatment-resistant gonorrhea threat is rising and doctors are now left with only one effective treatment for most cases of gonorrhea.
“These frightening developments could transform a once easily treatable infection into a global public health threat similarly to what is happening with the global emergence of carbapenem-resistant bacteria,” said Dr. Schweizer. “In the United States alone, 300,000 cases of gonorrhea are reported - and up to 600,000 estimated - annually. CRE infections and gonorrhea are just two examples of a number of emerging Gram-negative superbugs for which treatment options are rapidly disappearing – clearly a brewing public health crisis. In my laboratory, we continue to pursue answers to the development of antibiotic resistance in Gram-negative bacteria and hope that our work will help lead to new, effective treatments against these life-threatening infections.”