The global race to rein in superbugs; Shared From the Australian Financial Review

Antimicrobial resistance is a global problem that makes no distinction between “first world” and developing countries. Driven by the overuse and misuse of antibiotics, antimicrobial-resistant bacteria looms as an international public health disaster.

They are the cause of disease in hospitals, nursing homes and the wider community as sources of “super bacteria” proliferate. Drug-resistant microbes can be found in contaminated surfaces, water and food – even in seagulls.

A study led by Perth’s Murdoch University found Australian seagulls are infected with antimicrobial-resistant bacteria that cause serious infections in humans such as urinary tract infections and sepsis. Published in the Journal of Antimicrobial Chemotherapy, the study revealed that one in five seagulls tested were found to carry bacteria that were resistant to commonly used antimicrobial drugs.

A report from the Australian Commission on Safety and Quality in Health Care, Antimicrobial Use and Resistance in Australia (AURA) 2019, warns that despite the issuing of fewer prescriptions for antibiotics and antimicrobials, they continue to be overprescribed. As a result, some dangerous bacteria are growing increasingly resistant to common antibiotics and even last resort treatments.

The report warns that antimicrobial resistance shows little sign of abating and poses an ongoing risk to patient safety, with common pathogens such as E. coli, Salmonella, Neisseria gonorrhoeae and Neisseria meningitidis becoming increasingly resistant to major drug classes.

The AURA 2019 report found that overall use of antibiotics in the community fell between 2015 and 2017, the first decline in 20 years. But Dr Kathryn Daveson, clinical director of the AURA program, says that despite these gains, almost half the samples of enterococci tested in Australia were resistant to the antibiotic vancomycin – a level higher than in any European country.

“While the downward shift in prescribing will help to slow the spread of resistance, the levels of inappropriate prescribing of antibiotics in hospitals and the community are still too high,” Daveson says.

Dr Deborah Williamson, a clinical microbiologist at Melbourne’s Doherty Institute for Infection and Immunity, has called for urgent action to combat antimicrobial resistance (AMR). “If we don’t mount an appropriate response to AMR, we face a situation where common bacterial infections, like in the 1800s, may become untreatable,” she warns in a co-authored article for the Medical Journal of Australia.

While public health officials around the world grapple with reducing the over-prescription of antibiotics in the face of growing resistance, pharmaceutical giants are left to ponder the economic viability of investing in more powerful antibiotics.

The Geneva-based AMR Industry Alliance, a coalition of biotech, diagnostics, generics and research-based pharmaceutical companies, has called for more collaboration between governments and the private sector.

“Incentives are needed to overcome the challenge of high-risk investments that are difficult to sustain under the current conditions where new antibiotics will remain on the shelves as reserve and for use as a last resort, meaning there is very limited and unpredictable economic return on these products,” an alliance paper explains.

While investment in antimicrobial drugs is slowing, innovation is flourishing at the prevention end of the market.

New Zealand-based, ASX-listed biotech Zoono Group has produced a range of long-lasting, water-based antimicrobial products designed for use on skin, fabric and hard surfaces. Zoono CEO Paul Hyslop says there is global demand for Zoono’s range of consumer and commercial products as awareness of bacterial contamination grows.

Surfaces are a significant source of microbiological contamination, according to Hyslop, and are a major vehicle for harmful microorganisms.

“Bacteria, viruses, fungi and yeasts contaminate surfaces and can form biofilms that are extremely resilient to hygiene processes,” he says. “People are looking for smarter, non-toxic, safe, eco-friendly products that use less chemicals and won’t harm the environment.”

Hyslop says Zoono is “a next-generation biocide that contains no harmful chemicals and is less toxic than coffee”.

Zoono’s primary focus is the business-to-business market, which accounts for 70 per cent of sales. Its products are used in various settings including buildings, vehicles, shipping, aged-care homes and hospitals. The consumer business, which accounts for the remaining 30 per cent, is almost exclusively through online sales.

Its 14-strong product range includes sprays, wipes and foams for skincare, surface protection and mould remediation treatments.

“Zoono is unlike other technologies in that it kills pathogens on surfaces and then protects those surfaces from recontamination for up to 30 days for hard surfaces, 24 hours for skin and up to 50 washes for textiles,” Hyslop adds. “Our product is colourless, odourless, non-leaching, environmentally safe and non-corrosive. It kills pathogens, including bacteria, viruses, algae, fungi and mould but is not a poison.”

Hyslop cheerfully admits that “we’re making bold claims” which is why he has commissioned independent laboratory reports from Germany, the US, the UK, Japan and China to test the products “against all bacteria and virus groups”. “When a potential customer says ‘prove it’, we can,” he says.

Shared with permission from the Australian Financial Review 30 August 2019.