Ten years ago a North-East microbiologist warned that superbugs are evolving so rapidly that antiobiotics probably have only ten years of life left. Now the Chief Medical Officer has repeated his warning, says Health Editor Barry Nelson

IN 2002, the new chairman in infectious diseases at Durham University, Professor Adrian Walmsley, said mankind should take action in the constant battle against superbugs. And he warned that unless a new generation of antibiotic drugs could be developed within the decade, the superbugs could have the upper hand.

Ten years on, Prof Walmsley – now professor of molecular microbiology at Durham – says there is still no sign of a new generation of antibiotics being developed.

As a result, the world faces the prospect of going back to the pre-penicillin era before the Second World War when any bacterial infection – even a scratch on the knee – could prove fatal.

“At the moment we are hurtling towards disaster.

Bugs are going to be untreatable and we are going to go back to the time when we didn’t have any antibiotics,” says Prof Walmsley.

He blames the lack of incentives for the pharmaceutical industry to invest in antibacterial research and urges the Government – and other governments – to pour money into this field of research or risk disaster.

“There is no point in the Government waiting until there are lots of people dying in the hospitals to say we should do something. At that point we will be ten years away from having the new drugs.”

Last week, the Chief Medical Officer Dame Sally Davies warned that the threat of resistance to antibiotics posed by new strains of superbugs was so great it should be considered on a par with terrorism and climate change.

The problem is two-fold: antibiotics are routinely being over-prescribed by doctors – to keep patients happy – which helps bacteria learn how to resist them; and there are no new antibiotics being produced because they are not seen as profitable by big pharmaceutical companies.

“We haven’t had a new class of antibiotics since the late 1980s, and there are very few antibiotics in the pipeline,” said Dame Sally.

She said if urgent action was not taken in the next 20 years, what we now consider to be relatively simple surgical procedures, such as hip replacements and organ transplants, could become deadly, as medical developments are dragged back by 200 years.

“If we don’t take action, then we may all be back in an almost 19th Century environment where infections kill us as a result of routine operations,” she said.

So what exactly is going on? A new breed of drug-resistant bacteria, including strains of E.coli and Klebsiella, which causes pneumonia, is on the march. Found in the gut, they are extremely dangerous to older people and there is little that antibiotics can do to stop them. A new infection surfaces every year, while no new class of antibiotics has been developed since 1987.

MEANWHILE, doctors are prescribing 1.6 million courses of antibiotics every year – nearly one in 20 of which is an unnecessary prescription. The more antibiotics we take, the more end up getting flushed into the water system, where bacteria can adapt to resist them.

Dame Sally’s recommendations include better hygiene in schools, hospitals, care homes and public places. She is urging GPs to prescribe antibiotics only when necessary and urging patients not to demand the drug when it is not needed.

Scientists are still trying to develop types of antibiotic but, as fast as they are produced, bacteria develop strategies to avoid their effects.

Dame Sally advises better incentives and more innovation for pharmaceutical companies to develop new drugs, the biggest hope of winning the battle.

Meanwhile, Prof Walmsley has been working on a promising line of investigation since he last spoke to The Northern Echo. He is particularly interested in the possibility of finding a chink in the armoury of the bacteria that could make it vulnerable to treatment.

He and his team are looking at ways to disable a protective mechanism developed by bacteria.

Sometimes compared to the bilge pump of a ship, this incredibly tiny mechanism is activated when an antibiotic drug penetrates the outer membrane of the bacterium.

As the drug diffuses into the bacterial cell it triggers the production of protein pumps within the membrane, which can continuously pump out the drug so it is no longer a threat.

If the team at Durham University can work out how this mechanism works, they may be able to devise a method of blocking this process.

“There is a concern that even if you develop a new drug, the bacterial cell is instantly resistant to it because it automatically produces these pumps,” says Prof Walmsley. “We are trying to see if we can design small molecules that resemble the antibiotic drug but which won’t bind to the pumps and effectively prevent them from working.”

Teams of scientists in the UK, the US and Japan are also pursuing this highly-specialised line of research. But unless priority is given to the search for ways of combating bacterial disease, the future looks increasingly bleak, says Prof Walmsley.

“The Government needs to pick up on this and do something before it is too late. New drugs are not in the pipeline, and considering how long it takes before they come onto the market, we are talking about another ten years or so. It is vital we act now.”