Superbugs: What Are They and How Can They Be Stopped?

What Is A Superbug?

A superbug refers to a microorganism that has adapted after being exposed to antibiotics. The proper terminology for this is a multiresistant bacterium; the term ‘superbug’ has been popularised by the media.

Resistance to an antibiotic occurs when a microorganism grows in the presence of a concentration of antibiotic which would usually be sufficient to inhibit or kill organisms of the same species (Sabtu et al. 2015).

The severity of a superbug depends on the number of different antibiotics the microorganism is resistant to, with some being resistant to one or two, and others, resistant to multiple drugs (IMB 2017).

In 2016, a case of an infection caused by a ‘pan-resistant’ (resistant to all antibiotics) strain of bacteria was detected in the US for the first time, resulting in the death of a woman in her 70s. According to current research, Australia should anticipate the event of ‘pan-resistant’ bacteria in the near future (Bowden 2017).

It is estimated that antibiotic-resistant bacteria are responsible for more than 700,000 deaths worldwide, every year. A review by the UK government on antimicrobial resistance foresaw the number rising to 10 million by 2050 (IMB 2017).

A major risk of superbugs is that if they spread, we could reach the point where it becomes too dangerous to perform routine surgeries such as c-sections and transplants due to the risks presented by infection (IMB 2017).

Why Do Superbugs Occur?

The major cause of drug resistance is the overuse of antibiotics.

Almost all species of bacteria have developed some degree of resistance since the invention of antibiotics in the 1930s, but most are still sensitive to numerous classes of agents (Bowden 2017).

A smaller subgroup of bacteria (known as multiresistant strains) are only susceptible to a very limited range of antibiotics (Bowden 2017).

As antibiotics often cause unwanted side effects, it is not uncommon to be advised to change antibiotics more than once in the treatment of severe infection. If a person acquires a multi-strain bacterium, it is only a matter of time before treatment options become limited (Bowden 2017).

Research has shown that just one course of antibiotics can affect the level of drug-resistant bugs in a person’s body. It can also contribute to the wider issue of antibiotic-resistant disease in the community (ABC Health and Wellbeing 2017).

Antibiotic-resistant strains are not exclusive to developing countries. Brazil, Greece and South Africa have major problems with superbugs.

There is a strong correlation between countries with high incidents of antibiotic-resistant strains and countries where antibiotics are available over the counter (IMB 2017).

Traditionally, hospitals have been known to be the breeding site of the most serious infections, however, superbug infections are developing outside of hospital environments at an increasing rate (IMB 2017).

In the relatively recent event of global travel, the spread is only being exacerbated.

Keep in mind that while antibiotic resistance is a catalyst for superbug growth, the impact of a germ is not only dependant on whether there is an effective antibiotic available, but by the virulence of the organism, the volume the person is exposed to and the health of their immune system (Bowden 2017).

Superbugs in Australia

Cases in which people die from antibiotic-resistant infections are still relatively rare, particularly in Australia where antibiotics are not available over the counter (IMB 2017). This aside, it should still be considered a serious threat.

Clinical microbiologist Deborah Williamson argues along with other infectious disease experts that there is a current ‘black hole in surveillance’ in antibiotic resistance in Australia (Branley and Lloyd 2019).

Research emerging from the Doherty Institute identify the following microorganisms as being of primary concern:

• Carbapenem-resistant Enterobacteriaceae (CRE) A group of bacteria that appear to be resistant to carbapenems, which are very strong antibiotics:
• The number of cases of infections resistant to carbapenems has risen by more than 14%.
• Without treatment, roughly 40% of patients suffer death and many endure severe side effects.
• A yeast called candida auris is proving to be resistant to several antifungals and is thought to have come to Australia from overseas.
• Strains of gonorrhoea are displaying resistance to treatments, they are thought to have come from South-East Asia.

(Branley and Lloyd 2019, Bowden 2017)

How Can We Curb the Growth of Superbugs?

The following efforts are being trialled or have been suggested with the intention of stopping superbugs:

• Stricter prescribing laws around antibiotics would be a step toward limiting the impact of superbugs, along with tougher control around agricultural use of antibiotics.
• Researchers are looking for new antibiotics or enhanced versions of old ones already in use.
• A focus on diagnostic improvements in order to respond faster to an infection, getting a clearer picture of its resistance profile and therefore allowing it to be targeted earlier.

(IMB 2017)

A vital way to protect one’s self from superbugs is to follow recommended infection control procedures, such as:

• Wash hands with warm water and soap regularly.
• Dry hands thoroughly after washing them.
• Avoid coughing or sneezing into hands.
• Wash hands well after handling any raw animal products.
• Washing hands well after coming into contact with someone who is sick.
• Avoid sharing personal items such as razors or towels.
• Practice safe sex to prevent antibiotic-resistant gonorrhoea.
• Cook foods to safe temperatures.

Additional Resources

• World Health Organization, Antibiotic Resistance, https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

References

• ABC Health and Wellbeing 2017, 'Superbugs: What Are They and How are They Treated?', ABC News, viewed 28 January 2020, https://www.abc.net.au/news/health/2017-02-28/superbugs-what-are-they-and-how-are-they-treated/8310556
• Bowden, F 2020, ‘How Common Are Superbugs in Australia, and What Do We Do When the Antibiotics Don’t Work?’, The Conversation, viewed 27 January 2020, https://theconversation.com/how-common-are-superbugs-in-australia-and-what-do-we-do-when-the-antibiotics-dont-work-80318
• Branley, A and Lloyd, M 2019, ‘Antibiotic-Resistant Superbugs on the Rise and Leaving Patients with Life-Long Illness’, ABC News, viewed 27 January 2020, https://www.abc.net.au/news/2019-08-05/concerns-over-the-rise-of-resistant-superbugs/11377930
• Institute for Molecular Bioscience (IMB) 2017, ‘Explainer: What is A Superbug and How is it Treated?’, IMB University of Queensland, viewed 27 January 2020, https://imb.uq.edu.au/article/2017/11/explainer-what-superbug-and-why-should-we-be-worried
• Johnson, J 2019, ‘Superbugs: Everything You Need to Know’, Medical News Today, viewed 27 January 2020, https://www.medicalnewstoday.com/articles/327093.php#antibiotic-resistance
• Sabtu, N, Enoch, DA, Brown, NM 2015, ‘Antibiotic Resistance: What, Why, Where, When and How?’, British Medical Bulletin, Volume 116, Issue 1, pp. 105–113, https://doi.org/10.1093/bmb/ldv041

(Answers: b, a, c)