If the issues of antimicrobial resistance and multidrug-resistant pathogens are not addressed, we will head into a post-antibiotic era analogous to the 18th and 19th centuries. Common infections and minor injuries will once again kill people on a large scale. This is already starting to happen, says Professor Keertan Dheda, UCT director of the lung infection and immunity unit, to mark the founding of the Centre for the Study of Antimicrobial Resistance (CAMRA) at the university.
Professor Keertan Dheda, UCT director of the lung infection and immunity unit. Photo: UCT
This is first multidisciplinary unit in South Africa to address the origins and effects of antimicrobial resistance and to develop potential preventative strategies.
Given the high rate of drug-resistant tuberculosis (TB) in South Africa, and because it is a poverty-and HIV-related disease, Dheda believes the unit will place special emphasis on this area of antimicrobial resistance.
TB is now the foremost infectious disease killer worldwide and the most common cause of death in South Africa. Almost 25% of TB strains globally are resistant to at least one major TB drug and drug resistant-TB contributes heavily to TB mortality.
“Substantial morbidity and mortality due to multidrug-resistant infections, major health cost implications, and wider impact on society and the economy will not only retard economic growth, but there are also serious risks that it will undo the gains made under the United Nations’ Sustainable Development Goals,” Dheda adds.
No new antibiotics
The new centre will combine the efforts of several multidisciplinary national and international authorities in the fields of TB and antimicrobial resistance to study the movement and distribution of drugs in the body, molecular sequencing and the development of inhaled drugs.
Preventative strategies, antibiotics, vaccination, economic and psychosocial issues, and promotion of the appropriate use of antibiotics – also known as antibiotic stewardship – are among the many aspects of antimicrobial resistance that demand attention.
“A further worrying phenomenon is that there are hardly any new antibiotics entering the commercial pipeline. It is thus critical that newer and novel antibiotic classes be protected at all costs. However, this will not happen unless we understand the key drivers and pathogenesis of antibiotic resistance,” says Dheda.
Dheda emphasises that they know that exposing bacteria to levels of antibiotic below what’s required to be effective is a key driver of antibiotic resistance. What is not known, however, is to what extent this occurs in specific clinical contexts, how resistance evolves and how it will be possible to prevent or at least minimise the development and evolution of resistance using better strategies for dosage and administration.
The unit - funded by the South African Medical Research Council (SAMRC) - includes members and collaborators from the University of KwaZulu-Natal, University of Pretoria, Stellenbosch University, Walter Sisulu University, Sefako Makgatho Health Sciences University, National Institute for Communicable Diseases, London School of Hygiene and Tropical Medicine, University of Parma (Italy), and the Baylor Scott & White Research Institute in Dallas, Texas, in addition to those from UCT.
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