A hypervirulent antibiotic-resistant bacteria that could potentially cause the next pandemic has been found in more than a dozen countries, including Britain.
During a briefing, representatives of the World Health Organization (WHO) warned of the potentially deadly effects of a little-known bacterium called Klebsiella pneumoniae.
The pathogen has been found in the UK and the US, but also in Algeria, Argentina, Australia, Canada, Cambodia, China, India, Iran, Japan, Oman, Papua New Guinea, the Philippines, Switzerland and Thailand.
Of these countries, 12, including the UK, reported a specific strain of concern that has become a superbug, resistant to all antibiotics used to treat it.
This comes after WHO directors in a separate report named Klebsiella pneumoniae as a “high-risk” pathogen that could cause the next pandemic.
Although Klebsiella pneumoniae has been around for years, experts are increasingly concerned about a “hypervirulent” strain called hvKp. Pictured: A graphical representation of the Klebsiella pneumoniae bacteria
Although Klebsiella pneumoniae has been around for years, experts are increasingly concerned about the “hypervirulent” strain called hvKp.
In this context, “hypervirulent” means a greater chance of making healthy people seriously ill, not just groups such as the elderly or people with weakened immune systems such as cancer patients, who are traditionally more vulnerable to these types of infections.
To make matters worse, a particular substrain of hvKp, called hvKp ST23, has become resistant to “last-line” antibiotics called carbapenems, powerful cousins of the better-known penicillin.
These ‘last-line drugs’ are the last option left when a strain of bacteria such as Klebsiella pneumoniae has become immune to other, more common drugs. This process is called antimicrobial resistance.
This means that in many countries doctors have no choice but to try to keep a patient alive long enough for their body to fight the infection on its own, without direct pharmaceutical help.
And what’s worse, these strains can cause “outbreaks” and infect more people, the WHO report said.
Klebsiella pneumoniae is considered one of the leading causes of hospital-acquired infections.
Some studies estimate that it is the cause of one-fifth to one-third of pneumonias. Pneumonia is a general term for inflammation of the air sacs in the lungs, usually caused by an infection such as Klebsiella pneumoniae, acquired in a hospital.
The bacteria can also cause other serious health problems, such as urinary tract infections, meningitis, a dangerous infection of the membranes surrounding the brain and spinal cord, and even fatal sepsis.
While more than a dozen countries notified WHO that they had identified cases of Klebsiella pneumoniae strains of concern, only 43 of the 124 countries the global health organization asked for data responded.
This means that the true extent of global spread could be larger.
The WHO noted that the lack of testing for individual strains of the bacteria in some European countries may further contribute to an underestimation of prevalence.
“Since detection of hypervirulence is not part of routine diagnostic microbiology, hvKp may remain undetected,” the report said.
This graph shows the combined direct and associated deaths from antibiotic-resistant bacteria by world region measured in the new study. Africa and South Asia had the highest number of deaths per 100,000 people, but Western European countries such as the UK still recorded significantly high numbers of deaths
Figures showed a recent sharp rise in antibiotic prescriptions after years of decline. According to the UKHSA, 58,224 people in England had an antibiotic-resistant infection in 2022, four per cent more than in 2021.
The WHO added: ‘The clinical presentation and wide disease spectrum of hvKp have not yet been encountered by many clinicians in countries in the European Region.’
The WHO concluded its report by stating that based on current evidence, the risk posed by hvKp to global health is “moderate.”
It was recommended that countries increase their laboratory diagnostic capacity to better monitor HVKP cases and better analyze the genetic makeup of such strains for genes that increase the virus’s ability to infect and enhance the effectiveness of drugs.
Health officials in the United Kingdom have also noted a worrying decline in the effectiveness of drugs against Klebsiella pneumoniae in general.
A report from the UK Health Security Agency (UKHSA) published late last year detailed how Klebsiella pneumoniae was now 17.4 per cent resistant to antibiotics in frontline settings, up from 13.5 per cent in 2018.
The number of cases of Klebsiella pneumoniae is also increasing in England.
UKHSA data recorded a total of 11,823 cases in 2022/23, an increase of just over a fifth compared to the 9,806 cases recorded five years earlier.
It comes in a separate WHO report that names Klebsiella pneumoniae as one of more than 30 pathogens likely to cause the next pandemic.
The growing threat of Klebsiella pneumoniae is just one example of a pressing global problem known as antimicrobial resistance (AMR).
Experts warn that the emergence of pathogens that have become resistant to the drugs patients typically take to combat them will make the Covid pandemic seem “small” by comparison.
Professor Dame Sally Davies, England’s former chief medical officer, has warned that AMR could kill more people globally than climate change if the threat is not taken seriously.
An estimated 1.2 million people die from AMR each year worldwide, more than from HIV or malaria, and another 5 million die.
In the UK, it is estimated that almost 8,000 Britons die from AMR each year, while many more suffer long-term health problems from the infection.
The WHO itself predicts that the global direct death toll from AMR will rise to 10 million per year by 2050.
Globally, overuse and inappropriate use of medicines such as antibiotics is one of the major factors behind the development of AMR by bacteria.
This involves people taking medications such as antibiotics when they don’t need them, as well as giving them to farm animals on an industrial scale in an attempt to prevent infections and increase profits.
Such agricultural use can release large quantities into the environment, where pathogens can develop resistance.
Experts warn that as AMR becomes more widespread, it could lead to surgeries such as C-sections and treatments that weaken the immune system, such as chemotherapy and organ transplants, becoming much riskier, with potentially fatal consequences.
One possible way to combat AMR is to develop new types of antibiotics to which pathogens have not yet adapted.
However, such breakthroughs have not occurred since the 1980s.
One barrier to developing new drugs is cost. Industry estimates put the cost of developing a single new antibiotic at £1 billion, well below the estimated annual revenue from selling a single antibiotic of around £35 million.
Yields are expected to be so low because health authorities are only using these drugs as a last resort, in an attempt to prevent or delay pathogens from developing new resistance to the drugs and returning AMR to square one.
Several financing models have been proposed to solve this problem, such as a subscription model where companies are paid annually for access to superbug drugs, regardless of use. However, these models have not yet borne fruit.