SA scientists hope to better understand the extent of antimicrobial resistance infections in hospitals soon as a major study examines an increasing rate of infections.
A not-for-profit organisation that develops new treatments for drug-resistant infections, the Global Antibiotic Research and Development Partnership (GARDP), and the SA Medical Research Council (SAMRC) said on Monday they had launched a local study of hospital acquired infections, which render previously effective antibiotics useless.
It is hoped the study, which launched at Livingstone Hospital in Gqeberha this month, could improve antibiotic treatments and reduce illnesses associated with these hospital superbugs.
Data from 150 patients being treated for infections caused by carbapenem-resistant (CRE) organisms across five hospitals in SA will be collected and analysed. CRE infections often happen in healthcare settings and include Escherichia coli (E. coli) and Klebsiella pneumonias.
Other hospitals taking part are Cape Town tertiary facilities Groote Schuur and Tygerberg, Chris Hani Baragwanath Academic Hospital in Soweto and King Edward VIII Hospital in Durban.
Adrian Brink, clinical investigator for the study at Groote Schuur Hospital, said there was limited data from African countries “on the demographics, risk factors and clinical outcomes of hospital patients affected by carbapenem-resistant infections”.
“The serious bacterial infections — SBI-CREP study — will provide fundamental information that could be used to improve treatments and work towards reducing deaths and illness associated with these infections. Through a central microbiology laboratory, the study will also provide much-needed data on the molecular epidemiology of the bacterial isolates responsible for CREP infections.”
Researchers will also assess the capabilities of hospitals involved to carry out clinical trials with a goal of building capacity in the region. “This support for the sites could pave the way for future interventional trials, which will generate high-quality data to assess the effectiveness of novel therapeutics to fight carbapenem-resistant infections.”
The study will continue into 2023 in SA and extend to six hospital sites in India in early 2023.
It will also look at the epidemiology and treatments administered to adults and children, with severe infections caused by CREP, and collect data on the clinical outcomes for patients with confirmed CREP infections in the five hospital sites.
A study recently published in The Lancet showed that nearly 1.3-million people — and potentially millions more — died as a direct cause of antibiotic resistant infections in 2019. It reported Africa had the highest death-rate from antibiotic-resistant infections in the world. Hospital-acquired infections are among the deadliest of these resistant infections, which urgently require new and improved treatments.
François Franceschi, leader of GARDP’s project for serious bacterial infections, said: “We are seeing rising rates of resistance to carbapenems, the class of antibiotics most commonly used to treat hospital-acquired multidrug-resistant bacterial infections. This is a global health emergency that requires urgent action.”
Meanwhile, the World Health Organisation (WHO) has updated the list of priority pathogens that could cause outbreaks and pandemics. WHO said the list was updated to guide global research and development and investment, especially in vaccines, tests and treatments.
As part of that process, which started on Friday, WHO is convening more than 300 scientists to consider evidence on more than 25 virus families and bacteria.
The list was first published in 2017.
It includes Covid-19, Ebola, Marburg, Nipah and henipaviral diseases, Rift Valley, Zika, Lassa fever, Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) and disease X.
Disease X is included in an unknown pathogen that could cause a serious international epidemic. The experts will recommend a list of priority pathogens that need further research and investment. The process will include scientific and public health criteria, as well as criteria related to socioeconomic impact, access and equity.
For each pathogen identified as a priority, experts will determine knowledge gaps and research priorities.
Desired specifications for vaccines, treatments and diagnostic tests can then be drawn up.
Michael Ryan, executive director of WHO’s health emergencies programme, said: “Targeting priority pathogens and virus families for research and development of countermeasures is essential for a fast and effective epidemic and pandemic response. Without significant research and development investments before the Covid-19 pandemic, it would not have been possible to have safe and effective vaccines developed in record time.”
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