The World Health Organization (WHO) has identified antimicrobial resistance as one of the top ten global public health threats to humanity. Experts even have estimated that up to ten million people could die every year by 2050 as a result of antibiotic resistance.
What is antimicrobial resistance and what causes it?
Antimicrobial resistance (AMR) occurs when germs such as bacteria, viruses or fungi change over time and no longer respond to drugs designed to kill them. This increases the risk of spreading disease, serious illness and death. In addition, AMR causes antibiotics and other antimicrobial drugs to become ineffective, making infections difficult or impossible to treat.
AMR occurs naturally over time through genetic changes, and antimicrobial-resistant organisms are found in humans, animals, food, plants, and the environment. However, the main cause of antibiotic resistance is the misuse and overuse of antimicrobials, especially antibiotics.
When antibiotics are used, some bacteria die, but resistant bacteria survive and can multiply. The more we use antibiotics, and the more people don’t take antibiotics as directed, the higher the chance that antibiotics won’t work when we need them in the future. As bacteria become increasingly resistant to antibiotics, even common infections become difficult to treat and can become life-threatening.
Recently, the CDC’s special report on the impact of COVID-19 on antibiotic resistance in the United States concluded that the threat of antibiotic-resistant infections has increased during the pandemic. A major driver of this growth was the “…significant increase in antimicrobial use, difficulties in following infection prevention and control guidelines, and a resulting increase in healthcare-associated, antimicrobial-resistant infections in US hospitals.” Additionally, antibiotics were often first Option to treat patients with COVID-19 even when research showed antibiotics were ineffective.
The problem is further exacerbated by the lack of new antimicrobials and access to quality medicine, particularly in developing countries. Other causes include lack of clean water, sanitation and hygiene, poor infection and disease prevention and control, and lack of awareness and knowledge.
Drug resistance in viruses
Antiviral drug resistance is a growing concern in immunocompromised patient populations due to ongoing viral replication and drug exposure. Resistance has developed to antiviral drugs such as antiretroviral drugs.
All antiretroviral drugs are at risk of becoming partially or completely inactive due to drug-resistant HIV. The increasing resistance has become alarmingly high. For example in sub-Saharan Africa, over 50 percent of infants newly diagnosed with HIV carry a virus that is resistant to NNRTIs, a class of drugs used to treat HIV.
Drug resistance in bacteria
High levels of resistance to antibiotics, which are commonly used to treat common bacterial infections, have been observed worldwide, suggesting that we are running out of effective antibiotics.
For example, Staphylococcus aureus, known as MRSA, is a type of bacteria that is difficult to treat due to resistance to antibiotics. MRSA most commonly causes skin infections, but it can also cause pneumonia. And when the infection gets severe, it can cause sepsis. According to the WHO, people with methicillin-resistant Staphylococcus aureus (MRSA) infections are 64 percent more likely to die than those with drug-sensitive infections.
Drug resistance in malaria
One of the greatest threats to malaria control is the emergence of drug-resistant parasites. Artemisinin-based combination therapies (ACTs) are used by most malaria-endemic countries to treat P. falciparum, the predominant type of malaria most likely to progress to severe forms.
Lately released Evidence shows the occurrence of mutations associated with partial artemisinin resistance in Rwanda. If resistance to artemisinin and ACT partner drugs persists, it could pose a major public health challenge.
How can we avoid this crisis?
AMR is a complex problem that requires a unified multisectoral approach. Simply put, we can avoid this crisis by using antibiotics more cautiously, developing new antibiotics and tools to treat antibiotic-resistant infections, preventing the spread of AMR and preventing infections. Unfortunately, these three tactics are much easier said than done.
The WHO believes that applying the One Health approach is the best solution to prevent the spread of AMR. This approach involves partnerships across sectors, population levels and disciplines to achieve optimal health outcomes. Following this philosophy, many organizations and partnerships have formed to address the problem of AMR.
For example, in 2015 countries committed to the Global Action Plan on Antimicrobial Resistance. To ensure global progress, the countries in the partnership need to ensure the costs and implementation of national action plans across sectors to ensure sustainable progress.
Similarly, in 2018 the United Nations (UN) established the Interagency Coordination Group on AMR. In 2019, the group presented its report “No Time to Wait: Safeguarding the Future from Drug-Resistant Infections‘ to the UN Secretary-General. The recommendations proposed in this document are now being implemented, such as: B. Providing equitable and affordable access to quality antimicrobials and investing in new antimicrobial medicines, diagnostics, vaccines and waste management tools.
Scientists & Companies
Many scientists and companies are testing alternative ways to prevent AMR. For example, researchers have found that a naturally occurring compound has the potential to kill drug-resistant bacteria. The compound known as hydroquinine is found in the bark of some trees. It’s already known to be effective against malaria, but new evidence suggests hydroquinine could be used in new antimicrobial drugs to fight infection.
As for companies, Janssen, a Johnson & Johnson pharmaceutical company, is using one of nature’s ways to control bacteria: bacteriophages. Bacteriophages, also known as phages, are a group of viruses that infect and kill bacteria. Bacteriophages break down the bacterium’s DNA so that it cannot survive.
dr James Mersobn, Ph.D., Global Therapeutic Area Head of Infectious Diseases at Janssen, told us on Tomorrow’s World Today, “We believe this will be a fundamentally new way of dealing with antimicrobial resistance.”
For more information on antimicrobial resistance and the future of medicine, we visited the laboratories of Atara and Janssen. Check out what we discovered today on Tomorrow’s World Today on Saturday, September 24 at 8:30 am EST on the Science Channel and Sunday, September 25 at 6:30 pm on Discovery.
For more medical blogs, see Why Experts Predict Serious Illness 2022-2023 flu season.