di Francesco de Augustinis
Ogni anno nel mondo muoiono 700 mila persone per infezioni batteriche che gli antibiotici non riescono più a curare, a causa dell’antibiotico resistenza. In Europa il conteggio più recente parla di 33mila morti l’anno. L’Italia è maglia nera, con un bilancio di 10 mila decessi l’anno direttamente collegati alla perdita di efficacia di questi farmaci.
«Abbiamo un profilo del tipo di paziente che ha queste infezioni antibiotico resistenti», afferma Annalisa Pantosti, responsabile del programma contro l’antibiotico resistenza all’Istituto superiore di sanità.«Sono pazienti in genere anziani, perché all’interno degli ospedali la popolazione più rappresentata è tra i 65 e gli 85 anni». Gli ospedali sono uno dei principali luoghi dove si trasmettono infezioni batteriche, che colpiscono in particolare persone anziane o affette da altre patologie: «Chiaramente la terapia intensiva è il reparto dove ci sono più casi, seguita però dalla medicina e dalla chirurgia», riferisce Pantosti. «Anche reparti più generali hanno un numero sostanziale di casi».
Il problema della perdita di efficacia di antibiotici è direttamente collegato all’eccessivo utilizzo di questi farmaci negli ospedali, tra i medici di base, in ambito zootecnico. Un utilizzo diffuso, che genera batteri resistenti, che poi vengono «trasportati» attraverso l’ambiente, le persone o persino il cibo. «C’è una carenza di informazioni», afferma Dominique Monnet, responsabile del programma sull’antibiotico resistenza per il Centro europeo per la prevenzione e il controllo delle malattie infettive (Ecdc). «Ad esempio quando i pazienti prendono antibiotici, questi pazienti saranno a rischio infezioni da batteri resistenti nel futuro. Oppure, anche una persona sana può essere portatrice di batteri resistenti».
Nelle scorse settimane l’Ecdc ha pubblicato un report aggiornato sui dati di consumo degli antibiotici e sull’andamento delle resistenze in Europa. Dopo anni di notizie negative, il report contiene segnali positivi di riduzione delle resistenze in diversi Paesi, che dimostrano l’impatto delle strategie adottate dai vari Paesi europei, tra cui l’Italia: «Il tasso di consumo di antibiotici in Italia è alto rispetto ad altri Paesi», afferma Monnet. «Ma abbiamo mostrato che negli ultimi anni c’è stato un calo. Quando le persone sono consapevoli, non chiedono, non usano e non prescrivono farmaci antibiotici in situazioni in cui non sono necessari».
Segnali positivi di riduzione dell’eccessivo utilizzo di antibiotici arrivano anche dal settore zootecnico in Italia, che però è ancora ai primissimi posti in Europa per l’utilizzo di questi farmaci. «Dobbiamo renderci conto che la nostra situazione richiede un esame approfondito», ha detto Giancarlo Belluzzi, medico veterinario, all’ultima edizione della Giornata della suinicoltura a Cremona, proprio dedicata alla questione della resistenza agli antibiotici. «I dati che sono stati pubblicati ultimamente (Esvac, ndr) ci mettono in una luce non proprio di rispetto su questo tema. Siamo i secondi nella classifica di utilizzatori di queste molecole in Europa, prima di noi c’è soltanto Cipro, dopo di noi c’è la Spagna».
Proprio gli allevamenti di suini sono uno dei principali responsabili dell’uso di antibiotici in ambito zootecnico in Italia, in particolare per «trattamenti di massa», somministrati a interi gruppi di animali tramite i mangimi medicati. «In Europa in media un suino riceve antibiotici per 18 giorni, su un’aspettativa di vita media di 200 giorni», afferma Jeoren Dewulf, ricercatore dell’Università di Ghent, in Belgio. «Significa che in media durante il 9 per cento della vita del suino, l’animale riceve antibiotici. Se lo rapportiamo a un uomo, significherebbe che ognuno di noi prende antibiotici per un mese intero ogni anno». L’uso di antibiotici è concentrato nelle prime settimane di vita dei suinetti: «L’utilizzo è prevalentemente nelle prime fasi di vita dell’animale, il che dimostra un uso strategico, preventivo degli antibiotici», continua Dewulf. «Non è la cura a una patologia, ma è l’uso di antibiotici per prevenire l’insorgenza delle malattie». «Qualcuno potrebbe dire che non ci sono problemi per la salute umana, perché non ci sono antibiotici nel periodo vicino alla macellazione», conclude il ricercatore. «Ma è del tutto falso. Questo uso nella fase iniziale è molto efficace nel selezionare batteri resistenti. Poi possono scomparire i residui degli antibiotici, ma i batteri resistenti rimangono nell’animale fino al momento della macellazione».
Fonte: Corriere.it
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