Urinary Tract Infections Are Becoming Antibiotic Resistant. We Should Be Alarmed
It's a pressing concern to Australia, say experts -- and not just for those who contract this common infection.
Urinary tract infections (UTIs) -- one of the most common infections in Australia and around the world -- are becoming antibiotic resistant. We should be alarmed.
'Antibiotic resistance' is a bit like one of those end-of-days catastrophes that's easier to ignore entirely rather than engage with on an intellectual level. Sure, the World Health Organisation (WHO) is deeply concerned about it putting "modern medicine at risk", but unless it affects you, it's easier to switch off.
Unfortunately, a raft of literature published over the last few years paints a concerning picture for doctors and people who suffer the burning pain alike: UTIs, once easy to treat with antibiotics, are becoming less so.
Infectious diseases are on track to kill as many people every year as before the introduction of antibiotics by 2060, says Professor Ian Henderson, a researcher at the University of Queensland's Institute of Molecular Bioscience.
Already, Australia has seen a 300 percent increase in people dying from infections since the 1980s.
His work looks at understanding what's going on at a molecular level in bacteria. He says the most problematic antibiotic resistant infections are caused by 'Gram-negative' bacteria, which includes E. coli -- i.e. the most common cause of community-acquired UTIs.
"These Gram-negative are the ones the WHO is really worried about, because they're becoming multi-drug resistant," he said. "They're the organisms for which we're now running out of antibiotics."
In Asia and Europe, it's estimated that 25 to 50 percent of bacteria causing UTIs are resistant to at least some form of antibiotics.
"We're seeing it in Australia -- not on the same level, but the bacteria are at our doorstop," microbiologist Mark Schembri, a leading researcher on the subject also at the University of Queensland, told 10 daily.
Some of the most common antibiotics used to treat UTIs, such as Trimethoprim, are already becoming ineffective against some strains of bacteria, Schembri said. More worryingly, there's increasing resistance to some of our 'last line' antibiotics as well.
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"There will be some individuals who may well get a UTI with a bacteria which is resistant to all kinds of antibiotics, which leaves very little in the option of treatment," Schembri said.
In practical terms, that means more people who were once able to be treated in the community (a.k.a. by a GP) will need to be hospitalised instead, putting a huge drain on resources and leaving them open to infection.
Young, sexually active women, post-menopausal women and older men with prostate issues are the most likely people to contract UTIs, urologist Prem Rashid, vice president of the Urological Society of Australia and New Zealand, told 10 daily.
However, hospitalisation is usually only required for more complex infections, such as when an infection travels up the urethra and reaches the kidneys. In the absolute most extreme cases, it can reach the blood, causing shock or even death.
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"Twenty years ago, you'd get what we call a simple UTI," Rashid said.
"You had a range of antibiotics you could use. These days we're seeing a range of resistance to the bacteria which you would not have seen many years ago. And that's becoming more common."
Part of the problem here is that there's plenty of aspects of the disease we don't understand, says Schembri. It's not just about prescribing antibiotics smarter, but about developing new treatments for the bacteria itself, as well as coming up with solutions for more preventative measures.
"We need a multi-pronged attack," he said. "And it can't be done without appropriately funded support."
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