- The predictions are 10 million people a year by 2050
will succumb to a superbug
and that's mortality that's more than cancer
at that point.
(dramatic upbeat music)
- Our skin is covered in bacteria
which people often don't necessarily realise and recognise.
(upbeat music)
A lot of the bacteria just live there happily
not causing any problems
but when you do surgery, so when you make a cut
in the skin, these bacteria on the skin
can suddenly get into the wound
and in that setting they instigate the infection
but exactly the reason why they go
from living happily and harmoniously on our skin
to causing problems in the wound
is something that we're really only
just beginning to understand.
- Overseas they are definitely seeing increasing numbers
of superbugs than we are in Australia
as well as the superbugs are more extreme.
(upbeat music)
I think the fears are that these bacteria
are extremely smart and intelligent,
they've shown an amazing track record
to be able to get around our new antibiotics
all the time and I guess our fear is
that if we let our guard down
or if we take this for granted in some way
or take our antibiotics for granted in some way,
these bacteria will push on and really will become resistant
to everything that we have.
- There was a hiatus in the involvement
of pharmaceutical companies
in the development of antibiotics
that started probably about a decade and a half ago.
(upbeat music)
That led to significant concern
amongst governments around the world
and the United Nations and the World Health Organization
and as a result of that there've been various initiatives
brought into play to encourage pharmaceutical companies
to get back into antibiotic development
which fortunately they're starting to do.
- I define a superbug as a microorganism
that we've pushed to its evolutionary limit
in the sense that we've been using antibiotics
and antimicrobial agents against it for decades
and it's now starting to fight back
and we don't have the drugs or the chemicals
to combat it any longer.
(dramatic music)
In the '50s and '60s we found this miracle drug,
a drug and a chemical that could eradicate
and stop all bacterial infections
and we used that without much thought or concern
for the consequences
and I think now we're starting to pay for that
as a society.
- In agriculture we use antifungal sprays on our crops
and these are very similar to the antifungal drugs
that we would use in a hospital to treat a patient
with a fungal infection.
(dramatic music)
We also use antibiotics in agriculture.
Sometimes therapeutically to treat animals
to prevent infections but often not therapeutically
but rather because they improve the rate of growth.
You therefore have community-acquired infections
by superbugs as well
where people just by being out in this environment
can acquire infections
as the basis of superbugs.
In the end it will be the case that a simple scratch
from gardening could be something
that would give you a really dreadful infection
that may not respond to the antibiotics
that the hospital has.
- The public view of superbugs
is exactly what we're researching
'cause we don't know in great detail
what people think.
(upbeat music)
We can analyse news media
and public messaging and look at how the message
is being given but knowing how people interpret it
is a big question.
It's early days but we're finding
that people don't know very much.
- I think as individuals, firstly awareness
and understanding of what we're dealing with
that it is a here and now problem,
it's not something that may be in the future,
it's definitely here and now.
And then I think as an individual
the most important thing is around understanding
of antibiotics and when there's appropriate
and then inappropriate use of antibiotics.
We should be going to our GP
and rather than expecting to have an antibiotic,
we probably should be questioning our GP
why would you be giving me an antibiotic for this?
- My experience is you need them
when you are incredibly ill.
The bug that created all this for me was streptococcal-A.
I remember being put into a medically induced coma,
so the intensive care staff were frantic
trying to work out what was going on.
Then I woke up and I'd been in a coma for 10 days.
I knew that I had been so sick
that I had barely scraped through
and I woke up and my hands were turning black
like you see on Egyptian mummies.
My legs were slowly turning black.
- She was given a broad spectrum antibiotic,
post exploratory surgery, which has a battery of antibiotics
one of them hit the nail on the head.
I'm alive because of that.
I believe I'm alive because I got antibiotics.
Yeah.
I've had three massive infections.
One, I lost my arms
and the other two thankfully, I was at the time
in hospital, and they worked it out
and then gave me the correct antibiotics.
- It's a sad truth that in Australia
as well as in other countries around the world,
there's very often too little funding
into the research that's required in order to understand
and build the knowledge base on which we would be able
to discover new drugs and new therapies.
- I've been working on the old antibiotic Colistin
along with Professor Lee also of Monash
for the last decade and a half.
Colistin is an old antibiotic
that was discovered in the 1940s
and came into clinical use,
in other words, administered to patients
in 1959 and then fell out of favor
due to concerns about it causing kidney damage.
Doctors, when they needed to start using Colistin again,
were basically shooting in the dark.
They didn't really know which doses to use
for particular patients,
so the work that we've been doing
is basically developing essentially
the large body of evidence for how to best use Colistin.
Pleasingly, those dosing guidelines
have been accepted by the European Medicines Agency
as the basis for their recently
modified dosing guidelines throughout Europe.
- Bacteria phage is a tiny, tiny virus.
It's a specialised virus that only infects
and kills bacterial cells.
So, it doesn't recognise or infect human cells.
When antibiotics were discovered and first applied,
a lot of phage therapy research
and phase biology research effectively stopped over night
and antibiotics became this miracle drug
that really saved humanity from bacterial infections
and phages were, for the most part, forgotten about.
A lot of labs and institutes in Poland,
in Georgia, in Russia continued on with phage
not only research but also therapy
and still to this day,
one of the biggest phage therapy clinics in the world,
the Eliava Institute is based in the Republic of Georgia
in Eastern Europe.
Phage therapy isn't being used in Australia
for a number of reasons.
There's a lot of fundamental biology and research
that we still need to do
to really understand how they work
and how we can best use them
to treat these antibiotic-resistant infections in patients.
It's happening slowly and I'm positive
that we will see effective phage therapy in Australia
within the next decade.
- My work involves studies in a laboratory
where we look at the effects
of different antibiotic treatment
on difficult-to-treat bacteria.
(dramatic music)
We get the bacteria from patients from the hospital,
so that's patients with difficult-to-treat infections
and then in the lab we can expose the bacteria
to all sorts of different antibiotic treatments
including high doses or different ways
of delivering the antibiotic.
We'll also test antibiotic combinations.
In this way we can simulate what happens in the human body
and find out how these different types of treatments work.
- People need to take responsibility
not to protect themselves but to protect others.
And there are issues there
about how we kind of cultivate that responsibility.
What we know from HIV, for example,
the communities who face that risk
were the first ones to galvanise and act
and create strategies for moderating the impact,
so we got a lot to learn about how communities
are facing these problems to deal with them.
- The ultimate irony is that as we get better and better
at defeating cancer through the research investment
that's being made and the clever therapies
that have come about,
more and more of the people who die as a result of cancer,
will die from infections.
That will be their fate and I just think
this is such a dreadful dilemma
that we really have to up our game
in terms of what we do
looking into research on infections, on microbes,
on bacteria, on fungi to make sure
that this terrible tragedy doesn't eventuate.
(dramatic music)