Slow responses mean that multiple germs have more time to adapt

Dec 4, 2013 16:35 GMT  ·  By
Detecting resistance to antibiotics in bacteria needs to be a continuous process, experts argue
   Detecting resistance to antibiotics in bacteria needs to be a continuous process, experts argue

Antibiotic-resistant bacteria are a huge burden for hospitals and patients alike, since they are extremely difficult to kill, and even more difficult to eradicate from hospitals. A new paper reveals how slow responses from authorities and the pharmaceutical industry are allowing the microorganisms even more time to evolve their deadly capabilities. 

Being unable to destroy bacterial infections in patients is bad enough, but what is even worse is the danger of an outbreak occurring at any time. It stands to reason that this can only be avoided by identifying dangerous bacterial strains, and killing them off before they can mutate further.

The majority of modern hospitals provide patients with automated lab tests meant to detect if they are infected with superbugs. This allows doctors to determine the antibiotics these bacteria are sensitive too, and to start treatment accordingly.

However, the mechanisms involved in resistance to various antibiotics pass very swiftly between bacterial colonies, so this is a race against the clock. The US Food and Drug Administration (FDA) plays an important role in this fight, since it periodically mandates test machine manufacturers to update their discovery protocols.

What the new research found was that the rules the FDA released for a superbug called carbapenem-resistant Enterobacteriaceae (CRE) are still not being implemented, even though they were released some time ago. Carbapenem is one of the most advanced antibiotics out there, and counts among our last lines of defense against bacterial infections, Nature reports.

Of the three large screening machine manufacturers in the United States, not one has upgraded their devices, or resubmitted them to the FDA for approval. Therefore, hospitals continue to perform tests with out-of-date machines, meaning that countless cases of CRE infections may go unnoticed.

“It is sad this is a man-made problem,” says University of California in Los Angeles (UCLA) clinical microbiologist Janet Hindler. A source of further delays are the disagreements between the FDA and the Clinical and Laboratory Standards Institute (CLSI), the non-profit charged with setting up guidelines.

In the particular case of CRE, CLSI finished its guidelines in 2010, and the FDA forwarded them to manufacturers in 2012. This means that the two years in between these exchanges saw many patients improperly diagnosed with non-resistant infections, when their conditions were in fact more serious.

In addition, the FDA oftentimes requires screening machine manufacturers to conduct additional studies on their resubmitted detectors, which cost tens of thousands of dollars, and can take up to three years to complete. Therefore, the application of new guidelines can be up to 5 or 6 years behind what the bacteria are doing, and this is a recipe for disaster.