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Facing the alarming truth about AMR

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My journey as a scientist was born out of a lifelong fascination with bacteria, their biology, and their biochemistry as the smallest and earliest forms of life on earth. Today, we are faced with an extraordinary situation in which pathogenic bacteria, parasites and fungi are becoming increasingly resistant to antimicrobials, threatening to send us back to a time when we were unable to easily treat infections like pneumonia or tuberculosis.

Life-threatening diseases such as bacteremia/sepsis, pneumonia, diarrhea and tuberculosis cause at least 15 million fatalities worldwide, annually. The alarming truth is that antimicrobial resistant (AMR) infections are present in every country, and are responsible for at least 700,000 of those fatalities every year. By 2050, it is predicted that AMR-related deaths could rise to 10 million annually, worldwide. 1-5

As we observe World Immunization Week, we see the burden of these diseases and the growing threat of AMR, and recognize the crucial need to develop preventive vaccines, particularly for vulnerable populations such as older adults. Vaccines will offer a new tool in the fight against AMR, adding a layer of protection on top of new antibiotics, increased awareness of the value of existing antibiotics, and implementation of better stewardship for the use of antibiotics.

In industrialized countries, there is an increased demand among aging populations for complex invasive medical procedures such as hip or knee replacements – procedures which can sometimes lead to a life threatening or disabling infection, often caused by Staphylococcus aureus (S. aureus). Older age is one of the risk factors for invasive extra-intestinal Pathogenic E. coli (ExPEC) disease. A common source for this type of infection are urinary tract infections (UTI). It is unnerving to consider that when either yourself or a loved one undergoes an operation, they could contract an infection that could cause surgical-site infections, invasive life-threatening bacteremia (presence of bacteria in the blood) or other serious life-changing complications.

European and U.S. studies have shown that extended spectrum beta-lactamase-producing E.coli (ESBL) and methicillin/multi-resistant S. aureus (MRSA) are the dominant bacteria in these regions.2,6,7 Meanwhile, countries like China, India and Russia are particularly impacted by drug-resistant tuberculosis (DR-TB), which is another leading contributor to AMR-related deaths globally.8

Janssen recognizes that AMR is a complex problem that is driven by many interconnected factors, and addressing it will require holistic solutions. In my role at Janssen, I work at the forefront of bacterial vaccines development for ExPEC and S. aureus, both of which are prone to AMR.2 The reason for our vaccine research prioritization is clear when you consider that there are more antimicrobial resistant ExPEC and S. aureus-related fatalities than all other bacterial infection-related deaths combined.2,6,7

AMR is one of the defining scientific, health and economic challenges of our time. Only through research, innovation and coordinated action across sectors will we be able to minimize the emergence and spread of AMR. At Janssen, we are taking action to be a part of the solution to AMR.

[1]. Review on antimicrobial resistance. Tackling drug-resistant infections globally: Final report and recommendations. Available at: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf. Last accessed April 2021.

[2]. Cassini A, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019; 19:56-66.

[3]. Rudd et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet 2020; 395: 200–11.

[4]. WHO. Baylor College of Medicine. Available at: https://www.bcm.edu/departments/molecular-virology-and-microbiology/emerging-infections-and-biodefense/introduction-to-infectious-diseases. Last accessed: April 2021.

[5]. WHO. Tuberculosis. Available at: https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Last accessed: April 2021.

[6]. Rhee et al. Prevalence of Antibiotic-Resistant Pathogens in Culture-Proven Sepsis and Outcomes Associated With Inadequate and Broad-Spectrum Empiric Antibiotic Use. JAMA Network Open. 3(4):e202899.

[7]. Weiner et al. Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network. 2015–2017. Infection Control & Hospital Epidemiology (2019), 1–18.

[8]. TB Alliance. The Pandemic. Available at: https://www.tballiance.org/why-new-tb-drugs/global-pandemic. Last accessed: April 2021.

Jan Poolman, Ph.D.
Jan Poolman, Ph.D.
Jan Poolman, Ph.D.
Jan Poolman, Ph.D., is Head of Bacterial Vaccines Discovery and Early Development and Disease Area Stronghold Leader for Bacterial Vaccines at Janssen Vaccines & Prevention B.V. In this role, he oversees the development of new vaccines against prevalent bacteria that are resistant to antibiotics. Earlier in his career, he contributed to the licensure of seven vaccines for pediatric use targeted against a range of diseases, including meningitis. Dr. Poolman is now focused on the development of bacterial vaccines that could help older individuals live longer and healthier lives.