Superbugs could kill 39 million people by 2050. Here’s what doctors say Canadian survivors need to change

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Melissa Murray regularly ran 6 miles a day – until a serious bacterial infection nearly left her leg dead.

Last summer, the Toronto woman who had been working 60 hours a week as an account executive suddenly needed around-the-clock care to recover from sepsis. The life-threatening condition is the result of an overreaction of the immune system to fight an infection.

Septic shock deprived Murray’s heart and kidneys of essential blood and oxygen, and her blood pressure fell dangerously low. To save her life, surgeons had to urgently cut away half a calf muscle and tendons plus the inside of the other leg.

“I kept saying it felt like there was a campfire in my leg,” Murray, 46, recalled of the “excruciating” ordeal in July 2023.

“The pain was so bad that I wanted to disappear from my body.”

Murray had one invasive group A streptococci (iGAS) bacterial infection that could not be treated with standard antibiotics. Doctors do not know how Murray contracted the infection. It can be caused by something as small as a cut in the skin while shaving.

Antibiotic-resistant microbes, also known as superbugs, are a major contributor to sepsis – and are perhaps the greatest international public health threat of our time. World leaders called antibiotic resistance “an urgent global health threat.” Here’s what patients and doctors say needs to change.

An urgent global threat

Bacteria live in or on us, often beneficial or harmless. But antimicrobial resistance occurs when the germs that can cause infections develop the ability to evade medications such as antibiotics.

During the United Nations General Assembly this week in New York, world leaders made the call antimicrobial resistance or AMR “a urgent global health threat”, and aimed to reduce the estimated 4.95 million associated human deaths per year by 10 percent by 2030.

As bacteria evolve over time, they can no longer respond to the antibiotics that once killed them. Infections are then more difficult to treat – and sometimes even impossible.

Sepsis is one of the devastating consequences of antimicrobial resistance. The resistance can also render a minor skin wound incurable or turn a routine operation into an opportunity for dangerous microbes to invade.

Antimicrobial resistance “is one of the leading causes of death in… [all] our countries right now, but the worst part of the news is that it will be the number 1 cause of death by 2050,” Barbados Prime Minister Mia Mottley, chair of the Global Leaders Group on AMR, told reporters at the UN. on Thursday.

Antibiotics are a precious resource. Bacteria acquire resistance genes from each other. If someone doesn’t take all the antibiotic pills prescribed, a single bacterium remaining in that person’s system can develop resistance and quickly pass on the benefit.

Dr. Alison Fox-Robichaud, scientific director of Sepsis Canada, witnesses the link between antimicrobial resistance and sepsis in the intensive care unit where she works.

“We can often cure the infection,” says Fox-Robichaud, a professor of medicine at McMaster University. “It takes longer to cure the sepsis, the consequences of that infection. But it means we may have to use fewer antibiotics for those serious bacteria that have acquired all those resistance genes.”

Fox-Robichaud said in Canada, 80 percent of people have this serious infections are identified in the emergency department, meaning they have picked up microbes in the community where they live. And a lot infections acquired in intensive care units are resistant to antibiotics, due to overuse of the drugs and the long stay of patients who are very susceptible against such infections due to co-occurring diseases, as well as invasive procedures such as placement of urinary catheters.

“It’s frustrating because I know we have infections that are vaccine-preventable,” Fox-Robichaud said, citing flu and pneumonia and RSV in older adults as examples. “If people took them, I wouldn’t see so many people in my intensive care unit.”

‘Like 3 tennis balls under my skin’

For Murray, the iGAS infection initially weakened her with vomiting, followed a day later by diarrhea that kept her awake overnight. Her temperature reached 40 degrees Celsius and persisted all day despite her taking fever-reducing pills.

As the sun rose, Murray said her legs felt strangely warm: “It was like three tennis balls under my skin,” she said.

Murray called her boyfriend into the room and they went to the emergency department.

She discovered that the hot, clenched skin was the result of cellulitis, a common but potentially serious bacterial skin infection. She said the pain from the infection was “thousands” of times worse than what she experienced during labor.

After 13 days in the hospital, Murray went home with a cocktail of IV antibiotics that doctors nicknamed the “Melissa blend.”

Antibiotics prescribed too blindly, says surgeon

Ara Darzi from Imperial College London is a surgeon who attended the UN meeting. He said he would like the world to adopt a new goal by 2030: diagnosing the type of bacteria causing the infection before prescribing an antibiotic.

“The supply of new antibiotics is not keeping pace with demand,” Darzi said in an email to CBC News. But for this approach to work, new therapies and vaccines, as well as new diagnostic kits, must be developed and made widely available.

“We wouldn’t dream of giving chemotherapy without knowing the type of cancer – why do we tolerate this in infections?”

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Thea Turcotte says her life was likely saved by an experimental treatment developed in Winnipeg for her periprosthetic joint infection.

Mathieu Poirier, assistant professor of social epidemiology at York University in Toronto, notes antimicrobial resistance of bacteria directly caused more than a million deaths in 2021 worldwideranging from common infections such as pneumonia to untreatable sepsis or tuberculosis.

Preventing infections through access to safe water and sanitation and improving vaccination rates are important steps to curb antimicrobial resistance, he said.

Poirier said people in North America and Europe are much more likely to use antibiotics and other antimicrobials than elsewhere in the world: “In many ways we are contributing more to the problem and not even dealing with the worst consequences.”

For Murray, the lingering effects of her infection, which happened a year ago, include patches of sore skin on her shoulders and a leg that she often has to hold up because of swelling. But she can now walk, with a cane, and can now drive short distances.

“I like to think I’m thriving because I’m alive.”