Dubai study reveals worrying rise in drug-resistant germs
A high number of travellers to the UAE could make the country susceptible to the growing global problem, medics say
Vital drugs used to fight off deadly infections are potentially losing their potency, a study carried out in four Dubai hospitals has found.
Researchers warned the high volume of travellers visiting the UAE may make the country particularly susceptible to the growing global problem of drug resistance. This is often driven by overuse of antibiotics due to which bacteria adapt and survive making medical treatment ineffective.
They looked at a group of antibiotics known as carbapenems often used in patients who are seriously ill or have infections already resistant to other drugs.
Bacteria were isolated from the bodily fluids of patients at the government-run Dubai Hospital and Rashid Hospital, and the privately-owned American Hospital and Mediclinic City Hospital, and were tested for their resistance to antibiotics.
The study found that of about 2,000 samples, almost a quarter or 23.9 per cent, showed reduced susceptibility to the drugs. The authors said there are no previous Dubai studies to directly compare the findings to, but similar research found resistance rates were 15 per cent in Oman, 41 per cent in Lebanon and 52 per cent in Saudi Arabia.
Some of them are highly and disturbingly resistant and would present real treatment difficulties
Professor David Livermore, University of East Anglia
Some bacteria samples collected by researchers were of particular concern because they were resistant to multiple antibiotic types, not just carbapenems, said Professor David Livermore, a professor of medical microbiology at the University of East Anglia in the United Kingdom.
“Some of them are highly and disturbingly resistant and would present real treatment difficulties,” said Prof Livermore, who was not connected to the study.
He said the movement of people to Dubai from other parts of the world was likely to spread resistance in certain bacteria, as people pass on different resistant strains to each other. He said 23.9 per cent is "about double" what he would expect rates in the UK to be.
The authors of the paper, published in the International Journal of Infectious Diseases, backed up the theory. The issue has been pinpointed by the World Health Organisation as one of the biggest threats to global health, security and development, alongside dangers such as climate change.
Genetic analysis showed that about a third of the resistant bacteria produce an enzyme – a protein that promotes a particular chemical reaction – that breaks down carbapenems. Others had different biochemical defences against the antibiotics.
The academics, based at Zayed University, two universities in Lebanon and the four hospitals where the samples were collected, suggested in their paper that the “population flow into Dubai” may spread resistant bacteria.
They said that the city “remains a hotspot for interesting research in this field." Zayed University and Saint-Joseph University in Beirut, provided research grants for the study.
Antibiotic resistance is growing worldwide because the heavy use of antibiotics kills off susceptible bacteria while allowing resistant variants to multiply, making it harder for doctors to fight infections.
Prof Livermore, who has lectured in the Gulf region, warned that the spread of resistance could undermine doctors’ ability to control “classical diseases” such as gonorrhoea and typhoid and could threaten some “high-tech” medicine, including organ transplants.
In the UAE, there have been efforts to reduce use of antibiotics, with a conference hearing earlier this year that new rules, including a ban on pharmacies from handing over antibiotics without prescription cut use almost in half.
Demonstrating the scale of concern about antibiotic resistance, in a recent interview, Sally Davies, England’s chief medical officer, said that the spread of resistance was an equivalent threat to humanity as “extreme weather”.
A United Nations report has forecast that, unless action is taken, by 2050 as many as 10 million people could die annually because of antibiotic-resistant diseases.
Dr Sameem Majid Matto, an internal medicine and endocrinology specialist at the Canadian Specialist Hospital in Dubai that was not involved in the study, said that it was “not surprising” that resistance to carbapenems was increasing. The bacteria tested in the study is known as Pseudomonas aeruginosa, a frequent cause of hospital-acquired infections.
He said carbapenems were being used “excessively” to fight off infections without checking for the sensitivity of the bacteria.
“The rampant misuse of antibiotics, prevalent in not just our region but around the world, will result in a higher incidence of infections with antimicrobial-resistant strains,” he said.
If the “misuse” of antibiotics continues, Dr Matto said that it would be difficult in future to find antibiotics to treat infections or to develop new antibiotics.
“We have to stop the misuse of antibiotics. Consumption of antibiotics for treating viral infections has to stop. Antibiotics are useful in treating bacterial infections and aren’t effective against viruses,” he added.
Updated: February 9, 2020 12:05 PM