Even though Baden-Württemberg has had significantly fewer cases of MRSA than any other German state¹, there is no reason to sit back and relax. MRSA bacteria, i.e. methicillin-resistant Staphyloccus aureus species that have developed resistance to beta-lactam antibiotics, are the most common and best-known representatives of antibiotic-resistant bacteria. The number of infections with tuberculosis bacteria, which are becoming increasingly resistant to antibiotics, is also increasing in Baden-Württemberg.² If existing antibiotics are no longer effective and reserve antibiotics also fail, even mild infections and once eradicated diseases can become very dangerous. It is especially easy for bacteria to spread in places where there are large numbers of people, for example in highly frequented public toilets in airports³, and in particular in hospitals where people with severe infections or other diseases are treated. Immunocompromised patients are at a particular risk of infection. In addition to effective hygienic measures, early diagnosis can help prevent the transmission of the bacteria.

Hospitals and doctors usually send their patient samples to specialised diagnostic laboratories for analysis. Depending on the test method used, it can take several days before results are returned. Highly infectious pathogens can spread quickly as, logistically, it is impossible to isolate patients for the time it takes to analyse the sample and detect the pathogen. A rapid method of pathogen detection is therefore crucial so that appropriate therapy can be initiated and the spread of bacteria in hospitals prevented, thus helping to reduce the risk of resistance formation. A company called Hain Lifescience GmbH from Baden-Württemberg has developed modern test systems for detecting tuberculosis and other pathogens that help reduce the time it takes to obtain a result to a few hours.

Pathogens can now be diagnosed in hospitals and even emergency wards thanks to easy-to-use, fully automated systems. Highly specialised pathogen-specific diagnostic tools that deliver reliable results relatively quickly have now become available, thus enabling rapid isolation and effective therapy. SpinDiag GmbH, a start-up company from Freiburg, manufactures systems that enable doctors to detect drug-resistant bacteria directly from patient samples. The SpinDiag test can screen patients for the 25 most common antibiotic resistances upon admission to hospital. Infected patients can therefore be isolated immediately and the spread of the bacteria prevented.

Curetis GmbH from Holzgerlingen has developed a platform that uses different cartridges to identify various pathogens and antibiotic resistance markers for the simple and rapid identification of severe infections such as pneumonia, implant, tissue and blood infections.

New therapies are urgently required

Baden-Württemberg lies somewhere in the middle of all German states in terms of antibiotics prescription volumes. The Saarland has the unenviable record as the state with the highest volumes.⁴ Multidrug-resistant organisms (MRO) are a particular challenge because the enormous quantity of antibiotics taken over past decades has accelerated resistance development. Reserve antibiotics, i.e. antibiotics that are only used for destroying drug-resistant bacteria, are in many cases the last option. However, quite a few bacterial species have already developed mechanisms to deflect the action of reserve antibiotics too.

Medical researchers are under huge pressure to come up with new therapeutic options so that we will not be left without effective antibiotics in the near future. Identifying suitable drugs is far from easy. Substances that kill bacteria are available, but they are usually also harmful to patients. However, 88 years after the accidental discovery of penicillin, the German Centre for Infection Research (DZIF) at the University of Tübingen has had another stroke of luck in antibiotic research. The DZIF researchers have discovered that a bacterium in the human nose produces a previously unknown antibiotic compound that can destroy multidrug-resistant bacteria. The researchers’ results were published in the scientific journal Nature in July 2016.⁵ “Antibiotics are one of the most important inventions in medicine and we all need to use them responsibly in order to maintain their effectiveness and stop it becoming impossible to treat life-threatening infections at some point in the future. We are proud supporters of the small, medium and large companies in Baden-Württemberg that are developing diagnostic tools and medicines to counteract bacterial resistance as effectively as possible,” says Prof. Dr. Ralf Kindervater, CEO of BIOPRO Baden-Württemberg GmbH.

References:

1 Statista, Average number of MRSA* cases diagnosed in German hospitals in 2013; based on research carried out by the newspaper “Die Zeit”.

2 RKI – Epidemiological Yearbook of Notifiable Infectious Diseases 2015: http://www.rki.de/DE/Content/Infekt/Jahrbuch/Jahresstatistik_2015.pdf.

3 https://www.welt.de/wissenschaft/article159460848/Hier-gibt-es-besonders-viele-Killerkeime.html (accessed on  14th November 2016).

4 Zentralinstitut für die kassenärztliche Versorgung, Versorgungsatlas Newsletter 2/2016: http://www.versorgungsatlas.de/fileadmin/pdf/VA_Newsletter_Nr2-2016_Antibiotika_fin_web.pdf.

5 Andreas Peschel et al.: Human commensals producing a novel antibiotic impair pathogen colonization. Nature, 27th July 2016.