Infectious disease experts warn that new drugs are urgently needed to treat six drug-resistant bacteria that cause most hospital infections and increasingly escape the effects of antibiotics.
The ESKAPE pathogens -- as these six bad bugs have been dubbed -- are still on the loose more than four years after the Infectious Diseases Society of America (IDSA) first drew attention to the growing shortage of effective antibiotics. As the crisis of antibiotic resistance continues to grow, the latest IDSA "Bad Bugs, No Drugs" report examines the trickle of new antibiotics in the research and development (R&D) pipeline and proposes steps to tackle the shortage.
"The six bad bugs we call the ESKAPE bacteria -- Enterococcus faecium, Staphylococcus aureus, Klebsiella species, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species -- are among the biggest threats infectious diseases physicians face today," said Helen Boucher, MD, of Tufts Medical Center in Boston, lead author of the new report, published in the Jan. 1 issue of Clinical Infectious Diseases and now available online. "We desperately need new drugs to fight them. But we also need cooperation among industry, academia, and government to create a sustainable R&D infrastructure that will fill the pipeline to meet today's needs and keep it filled with drugs that tackle tomorrow's infectious diseases threats."
Amid the continuing downward trend in new antibiotics, the new report shows a few signs of hope. The Food and Drug Administration (FDA) has approved a small number of new antibiotics in the last several years, most of them active against methicillin-resistant Staphylococcus aureus (MRSA). However, just one can be taken orally (the rest are intravenous); they are too toxic for some patients to handle; and resistance to them is already beginning to emerge.
But the medicine cabinet is particularly bare when it comes to Acinetobacter, Klebsiella, and Pseudomonas. Called "Gram-negative" for the way they react to a common staining test used to identify bacteria in a microscope, they attack some of the most vulnerable patients, including those in intensive care units and long-term care facilities, burn victims, and those with cystic fibrosis. These especially bad bugs are becoming more and more resistant to antibiotics. Physicians are now facing some strains that are resistant to every antibiotic in the arsenal. Only one new drug was approved for gram-negative infections last year, and resistance already exists to other drugs in its class.