The World Health Organization has released its first-ever list of antibiotic-resistant “priority pathogens,” which details the 12 bacterial types that it believes poses the greatest threat to human health today and kill millions every year.

The list divides the 12 families of bacteria into three categories based on the urgency of the need for developing new antibiotics. It was drawn up to guide and promote research and development of the new drugs as part of the agency’s efforts to curtail the growing problem of superbugs or antibiotic resistance, officials said in a statement.

Dirty Dozen Of The Bacteria World

“Antibiotic resistance is growing, and we are fast running out of treatment options,” warned Dr. Marie-Paule Kieny, assistant director-general for health systems and innovation at WHO. “If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time."

Superbugs maintain a built-in ability to resist antibiotic treatment as well as transfer genetic material allowing other bugs to become immune to drugs as well.

The “Priority 1” or critical drug-resistant bacteria group hound hospitals, nursing homes, and facilities that involve critical devices such as ventilators and blood catheters. It includes carbapenem-resistant Enterobacteriaceae, which killed an elderly woman in Nevada and had become resistant to all antibiotics available in the United States.

These bacteria lead to severe, often-fatal infections of the bloodstream as well as pneumonia.

The second- and third-priority groups in the list include other drug-resistant bugs that result in more common conditions such as gonorrhea and salmonella poisoning via contaminated food.

Here is the complete list:

Priority 1: CRITICAL
1. Acinetobacter baumannii, carbapenem-resistant
2. Pseudomonas aeruginosa, carbapenem-resistant
3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing

Priority 2: HIGH
1. Enterococcus faecium, vancomycin-resistant
2. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
3. Helicobacter pylori, clarithromycin-resistant
4. Campylobacter spp., fluoroquinolone-resistant
5. Salmonellae, fluoroquinolone-resistant
6. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: MEDIUM
1. Streptococcus pneumoniae, penicillin-non-susceptible
2. Haemophilus influenzae, ampicillin-resistant
3. Shigella spp., fluoroquinolone-resistant

Tuberculosis, which is fast becoming resistant to traditional therapies, was excluded from the list since it is targeted by other unique medical programs. Other common bacteria such as streptococcus and Chlamydia were also not included because of low resistance levels and no substantial public health threat.

The WHO list was developed in partnership with Germany’s University of Tübingen, which used a multi-criteria decision analysis method endorsed by international experts. They selected pathogens based on the deadliness of the infection, whether the treatment entails long hospital stays, the frequency of resistance to existing drugs, the ease of spread between humans and animals, and treatments available, to name a few.

The Battle Against Superbugs

This week, G20 health specialists will be meeting in Berlin to address the need for more effective antibiotics to curtail drug resistance.

The Pew Charitable Trust’s antibiotic resistance initiative noted that no new class of antibiotics has been discovered and brought to market since 1984. In the United States, of the 40 antibiotic drugs currently developed clinically, fewer than 50 percent display the potential to treat pathogens on the WHO list, warned Pew senior director Allan Coukell.

“And based on history, most of those will fail to reach the clinic for reasons of efficacy or safety. So the outlook is grim,” he explained.

According to historical trends, a mere one out of five drugs reaching the initial testing phase in humans will be approved by the Food and Drug Administration. Antibiotics for superbugs are a tricky affair since only a small number of people contract the infections and meet the criteria for joining clinical trials.

Kieny clarified that their list is not meant to scare people worldwide but to signal R&D priorities to address the urgent problem.

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