IDSA calls for more antimicrobial research, development. IDSA officials identify a target list of six microbes that are in desperate need of new antibiotics.
by Colleen Zacharyczuk, IDN Managing Editor, March 2006

The IDSA “Hit List” of “superbugs,” or highly dangerous, drug-resistant microbes, that are most in need of research:

  • Methicillin-Resistant Staphylococcus aureus (MRSA)

  • Escherichia coli and Klebsiella spp.

  • Acinetobacter baumannii

  • Aspergillus spp.

  • Vancomycin-Resistant Enterococcus faecium (VRE)

  • Pseudomonas aeruginosa

Officials with the Infectious Diseases Society of America (IDSA) are calling on government officials to introduce and enact legislation that would offer market exclusivity to pharmaceutical companies that research and develop novel antimicrobials for “superbugs,” or highly dangerous, drug-resistant microbes.

They also identified a representative “hit list” of microbes that are most in need of research - methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Klebsiella species, Acinetobacter baumannii, Aspergillus species, vancomycin-resistant Enterococcus faecium and Pseudomonas aeruginosa.

In a press conference announcing the list, Martin J. Blaser, MD, president of the IDSA, and colleagues detailed complications associated with these microbes and the challenges involved in treating them.

MRSA infections constitute the single most important cause of health care-associated infections, increasing lengths of hospital stay, severity of illness, deaths and costs. Although these infections occurred primarily in hospitals, they are becoming increasingly common in communities nationwide, especially where groups of people are in close quarters, including military facilities, sports teams and prisons. The number of infected children jumped 28% between 2001 and 2004, according to Blaser. Although there are treatment options available for MRSA, most medications need to be administered by injection; oral drugs are desperately needed.

“[A. baumannii] is a prime example of a mismatch between unmet medical need and the current antimicrobial research and development pipeline,” wrote researchers in an article in Clinical Infectious Diseases, which announced the IDSA’s “hit list.” The bacterium is a growing cause of hospital-acquired pneumonia, and the number and hardiness of drug-resistant strains are growing, researchers said. Soldiers are also returning from Iraq and Afghanistan with cases of highly resistant Acinetobacter wound infections. In the case of A. baumannii, physicians have been forced to resort to an old drug, colistin, which had previously been abandoned as too toxic. IDSA officials said only one new drug is on the horizon to treat Acinetobacter infections, and it is considered to be too toxic for children.

Discussing the other organisms, Blaser and colleagues said that although there are treatment options for all of them, these bugs’ abilities to develop resistance have made treatment difficult. IDSA officials said there are relatively few new therapies in the pipeline for any of them.

A call to action

During the press conference, IDSA officials said that Congress has not passed the comprehensive legislation needed to stimulate the antimicrobial research and development that the IDSA called for in its July 2004 report, “Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates ... A Public Health Crisis Brews.”

In the most recent report, IDSA officials urged Congress to pass comprehensive legislation to encourage the pharmaceutical industry to re-enter the antimicrobial field. They state that members of Congress should establish a commission to set antimicrobial discovery priorities. They add that companies that develop novel antimicrobials should be rewarded with 10-year market exclusivity rights. Furthermore, IDSA officials said that research, development and manufacturing should be encouraged through tax credits. IDSA also is pressing for funding for antimicrobial resistance efforts at the CDC, including MRSA extramural research. Congress allocated funding to address potential agents of bioterror under the Project Bioshield legislation that passed two years ago; however, naturally occurring infections like MRSA were not included in that legislation.

“We are very concerned that Congress has not taken action to date or pass legislative incentives that will spur antimicrobial development or funding for resistance efforts. These bad bugs won’t wait, neither should we,” said Robert Guidos, JD, director of public policy for the IDSA.

For more information:

  • Talbot, GH, Bradley J, Edwards JE, et al. Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clin Infect Dis. 2006;42:657-668.