BioEd Online

You may not be familiar with Acinetobacter, Aspergillus and enterococci. But perhaps you should be. They are part of a line-up of malicious microbes from which, infectious-disease experts say, we should be running scared.

Drug-resistant bacteria and fungi pose a growing threat to human health. Because these organisms have figured out how to shrug off many drugs, doctors are more or less helpless to battle the life-threatening infections they cause.

To focus attention on the nastiest of these drug-resistant organisms, and the ones against which we are least prepared, a group of scientists working with the Infectious Diseases Society of America (IDSA), based in Alexandria, Virginia, has come up with a short-list of the six microbes they say we should be most worried about.

The authors of the report say that these organisms should be a top priority for drug research because there are so few new medicines being developed to fight them. "These are the bugs that clinicians are seeing and that are causing the biggest problem," says George Talbot, the lead author, who advises pharmaceutical companies on this type of research from his Pennsylvania company, Talbot Advisors.

They announce the list today and publish it in the journal Clinical Infectious Diseases¹.

Deadly line up

The roster reads like a who's who of microbial villains (see 'Most wanted'). Many people are already familiar with one character: methicillin-resistant Staphylococcus aureus (MRSA), the bug that underlies most of the drug-resistant infections in hospitals.

Concerns about MRSA have spiralled with recent reports that it is causing an escalating number of infections in the wider community, such as in military facilities, prisons and schools. "It's an epidemic in cities," says Robert Daum at the University of Chicago, who studies Staphylococcus aureus infections. "We're hospitalizing children like crazy."

Also on the list is the fungi Acinetobacter baumannii. Virtually unheard of 30 years ago, this organism is behind a rising number of hospital-acquired pneumonia cases in the general population, and infections in wounded US soldiers.

Call for cash

The IDSA is urging policymakers and pharmaceutical companies to put more effort into finding new antimicrobial drugs. Experts warn that drug firms are pulling out of this area because finding such therapies is difficult and expensive; firms stand to make more money from a drug that is taken over a lifetime.

The superbug hit list follows a 2004 report from IDSA that spelled out ways to spur research and development of new antimicrobial drugs². One of their proposals is that US lawmakers should grant tax breaks to companies that pursue this work.

But Baum reckons that the superbug crisis has yet to reach the point where many policymakers will sit up and take notice. And finding new antibiotics, he suggests, will require collaboration between academic research groups, biotechnology firms and pharmaceutical companies. "Somehow we need to create a community of people who think this is really important," he says.

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