Essay on Antimicrobial Resistance

Abstract

Antimicrobial resistance has huge global implications. According to experts, abuse of antibiotics and other antimicrobial drugs is the biggest catalyst of resistance development against medications. This article looks at the facts of antimicrobial resistance as well as the present state of the phenomenon on a global scale while also considering the plausible explanations for it and highlighting the interventions being made to manage the situation.

Introduction

Antimicrobial resistance occurs when germs adapt to existing medications and develop resistance. Therefore, illnesses which are caused by resistant microbes are no longer treatable through conventional methods. These ‘superbugs’ are resistant to antifungals, antivirals, antiprotozoals, and antibiotics, as well as other microbials (WHO). In order to treat superbugs, patients are required to stay in hospital longer, or returning to the hospital often to prevent or deal with recurrence (CDC).

In the event where conventional treatment is unsuccessful, alternative treatments may be expensive. Increasing the dosage of antimicrobials is a common course of action but carries greater risk of side effects. Greater still is the implication of antimicrobial resistant illnesses on the affected person and those around them; this will be the focus of this article. First, is the increased threat of communicability, followed by the assessment of the phenomenon’s impact/threat on a wider scale, plausible explanations for it, and eventually which interventions are in place to check antimicrobial resistance.

Literature review and Discussion

According to experts, abuse of antibiotics and other antimicrobial drugs is the biggest cause of resistance development against medications. This abuse is not only observed in humans but also in animal husbandry as well as agricultural processes. The most common circumstances where antimicrobials are mishandled include: self-treatment of common illnesses like colds and headaches of any magnitude without qualified supervision. In animal husbandry and food production, antimicrobials are used to promote growth and also protect them from animal infections. Moreover we come into contact with drug-resistant microbes through interactions with the environment including air and water where standards of cleanliness are poor and food production are not properly done (WHO).

The most concerning issue is the direct effect of antimicrobial resistant illnesses considering the rising communicability. Furthermore, studies show that resistance to drugs can be developed in anybody despite their age as well as animal, plant, and aquatic life. These multiple Channels of vulnerability make antimicrobial resistance a matter of urgent global concern (CDC). Estimates as of September 2018 indicated that a minimum of two million people are infected by drug resistant pathogens annually, resulting in upwards of twenty-three thousand deaths in the same span of time. The development of antimicrobials was critical to the advancement of medicine as we know it but they could be potentially be lost. Major interventions of medicine such as artificial joints and organs, treatment of chronic and otherwise terminal illnesses like cancer, diabetes, arthritis of the rheumatoid and asthma would be unviable because of their dependence on the effectiveness of antimicrobials foremost (CDC).

Soon after the introduction of penicillin as an antibiotic, resistant bacteria have also been observed and continue to share these traits with other bacteria which increases the difficulty of coming up with safer and equally effective medications. Recent figures state that there are more than twenty thousand potentially resistant pathogen genes which exist (Aslam et al, 1646). Like all living organisms, pathogens also change and adapt to new environments or aspects of their current environment and those which develop resistance have a higher chance of survival. Researchers propose that some microbes are naturally resistant to some of the known drugs. Others develop resistance through either generic mutation or by shared resistance.

It is uncommon for the genetic makeup of microbes to change naturally in a way that counteracts the action of an antimicrobial but they can acquire the trait from other microbes in various ways. Bacteria, for example can get resistant through mating with other bacteria thus exchanging genetic information. Secondly, viruses can act as carriers of traits that allow resistance in bacteria by attacking bacteria which are susceptible to antimicrobials. Finally, bacteria have the affinity for unattached strands of DNA in the area, allowing them to alter their form and prevent the therapeutic action of antibiotics. Despite the low possibility of generic mutation by pathogens, drug-resistant forms of illnesses are already common in the continental United States. The mutation of S. aureus and Enterococcus to resistant versions has caused bacteria to be declared as cause for alarm in public health institutions. Government agencies in the country have cited antimicrobial-resistant bacteria as public health crisis which has put it beyond treatment using antibiotics (Ventola, 280).

In February 2018, the World Health Organization confirmed the presence of antimicrobial resistance of bacteria in all the countries under its jurisdiction. In an assessment of various illnesses the body responsible for health oversight, in one hundred and ninety nations, issued an advisory that the prognosis for patients suffering from multi-drug resistant illnesses is likely to be poor, or even fatal. Furthermore, people with resistant illnesses will incur more costs to receive treatment (WHO).

The development of resistant strains of causative pathogens of some of the most common illnesses and conditions will make it difficult to perform required medical interventions by practitioners because of the risk involved. The rising costs of medical care will make the progress achieved by the Millennium Development Goals be reversed while reducing the chances of meeting the Sustainable Development Goals. A report by the world health body said that a significant minority of new tuberculosis cases are multidrug resistant, especially among people who are previously diagnosed. One hundred five countries have reported cases of extensively drug resistant form of Tuberculosis. Against malaria, the World Health Organization has made commendable progress towards total elimination of the viral illness. However, resistance to antimalarial medication, better known as ACTs has emerged in the Mekong sub-region which has necessitated the need for a comprehensive strategy to completely eradicate the disease by the year 2030. The strategic document has been adopted by six countries (WHO).

Conclusion

The world governing body, through its health organ, acknowledges the impact of antimicrobial resistant pathogens on a global scale. The complex nature of the related factors responsible for antimicrobial resistance is also societal and deliberate efforts are required to achieve success in reversing the established trend. Initiatives by World Health Organization such as World Antibiotic Awareness Week, Global Antimicrobial Resistance surveillance system (GLASS), Global Antibiotic Research and Development Partnership (GARDP), and Interagency Coordination Group on Antimicrobial Resistance (IACG) are being run by the world body. In addition, it provides technical as well as financial facilitation in partnership with other organizations and Heads of State to create and implement action plans against antimicrobial resistance (WHO).

To sum up, it is certain that the development of resistance to drugs in microbes is a real threat facing the entire world, without respect to age, gender, nationality or ethnic background. People who suffer from chronic illnesses are more susceptible to antimicrobial resistant illnesses while the cost of medical treatment for such illnesses is likely to go up. A price increase will make it unaffordable for millions of people around the world, leading to loss of many lives.

References

“About Antimicrobial Resistance | Antibiotic/Antimicrobial Resistance | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Sept. 2018, https://www.cdc.gov/drugresistance/about.html

“Antimicrobial Resistance.” World Health Organization, World Health Organization, 15 Feb. 2018, https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.

Aslam, Bilal, et al. “Antibiotic Resistance: a Rundown of a Global Crisis.” Infection and Drug Resistance, vol. 2018, no. 11, 2018, pp. 1645–1658., doi:10.2147/IDRS173867.

“General Background: About Antibiotic Resistance.” Wayback Machine, Alliance for the Prudent Use of Antibiotics (APUA) , 2014, https://web.archive.org/web/20151023035356/http://www.tufts.edu/med/apua/about_issue/about_antibioticres.shtml.

Ventola , C. Lee. “Part 1: Causes and Threats.” The Antibiotic Resistance Crisis, vol. 40, no. 4, Apr. 2015, pp. 277–283.