SHARES
We are only seeing the tip of the iceberg. They are getting into our community!
“Never has the threat of antibiotic resistance been more immediate and the need for solutions more urgent”, urges WHO Director-General Tedros Adhanom Ghebreyesus.
Antibiotic Resistance – A Deadly Global Threat
Every 15 minutes, a person would die from antibiotic-resistant infections. This is a looming danger that threatens our nation’s health and global security.
Globally, at least 700,000 people die each year from drug-resistant infections while 230,000 of whom die from multi-drug resistant tuberculosis. It is alarming that more and more common infections are gaining resistant to antibiotics! For instance, respiratory infections, sexually transmitted infections, and urinary tract infections that cannot be cured.
In essence, if this problem worsens, life-saving medical procedures such as surgery or even a needle prick can become too risky. Additionally, our food systems may become more and more uncertain. Given the situation, we can no longer protect our farm animals from infections!
Invasion of Antibiotic-Resistant Bacteria and Fungi
Disease causing bacteria and fungi will naturally continue to develop resistance to drugs designed to kill them. Every single time we expose them to such lethal weapons, a few survive to tell the ‘story’ and ‘teach others how to survive’. In fact, the surviving bacteria can pass on resistant genes directly to other bacteria even of different species. When it dies, its genetic contents are released into the environment, waiting to be picked up by another bacteria.
Urgent Threats
Most antibiotic resistance breeds from places where antibiotics usage is highest. For example, farms and hospitals. Even though policies are in place to ensure safe antibiotic use, the number of resistant bacteria continues to rise at the front lines. A number of them already emerge as urgent threats that endanger the lives of many patients. These includes C. difficile that causes bloody diarrh0ea, carbapenem-resistant Enterobacteriaceae (CRE) and carbapenam-resistant Asinetobacter that overcome one of our strongest and final line of defense, C. auris that is spreading like wildfire in hospitals and nursing homes, etc.
Serious Threats
Among the most serious resistant infections to date, methicillin-resistant Staphylococcus aureus (MRSA) has long been a problem in hospitals because it spreads easily between infected patients and healthcare workers. In 2017 alone, about 323,700 people fell sick to MRSA infections and 10,600 of them passed away. The worst nightmare of all, MRSA has spread beyond hospital settings into the community. There are reports of more and more cases of community-acquired MRSA.
Besides, extended spectrum beta-lactamase infections of enterobacteriaceae (ESBL) are getting more serious. It sickens about 197,400 people in a year and costs the lives of 9,100 persons. However, nearly half of the patients have not received recent medical treatment in the hospital, which means they had been infected early in the community. This is worrying as common infections in healthy people, such as urinary tract infection, may one day turn into a life-threatening disaster!
Once resistant bugs enter the community, it is almost impossible to contain nor isolate the germs to prevent further spread. The bacteria can spread to the masses and develop new forms of resistance. The whole society is at stake.
Source: Review on Antimicrobial Resistance from Public Health Post
Can We Develop New Antibiotics?
The pre-clinical plan shows great innovation and diversity with 252 entities under development. But, these products are in their infancy. Their safety profile and effectiveness remains a question. According to forecasts, the first 2-5 products will not be available for the next 10 years.
However, the list of antimicrobials for tuberculosis and Clostridium difficile are more promising. More than half of the treatments meet all of the WHO criteria for innovation.
Aiming to provide five new therapies by 2025, WHO and the Drug Initiative for Neglected Diseases have jointly created a non-profit research organization called the Global Antibiotic Research and Development Partnership. Currently, the company is working with more than 50 public and private partners in 20 countries to tackle the problem head-on.
More importantly, new treatments alone will not be enough to tackle the threat of antibiotic resistance. Scientists are working with countries and partners to improve infection prevention and control.
Photo by Dartmouth College from Flickr
“One Health” Approach
Recognizing that human health, animal, food and the environment are closely linked, the WHO report calls for unity of multiple sectors in a “One Health” approach. Antimicrobials are essential to protect human health as well as animal health and food production.
The result is The Expert Group that brings together partners from the United Nations, international organizations and people with expertise in human, animal and plant health, trade, development and the environment.
Recommendations call for prioritizing national action plans for more funding and capacity to handle the problem, stricter regulatory systems, as well as awareness-raising programs for the responsible. Also, prudent use of antimicrobial agents in healthcare and farming practices can go a long way.
Conclusion
Antibiotic resistant microbes are getting out of control. They spread beyond confinement into the community – an area where we are almost defenseless. We need more concerted effort to drive innovative solutions as well as putting into full execution all preventive measures to slow down antibiotic resistance. For our part, we need to be careful about the use of antibiotics. Talk to your doctor if antibiotic is necessary for you. Also, make sure to finish your antibiotic and give no chance for bacteria to develop resistance.
References:
1. Joint News Release. New report calls for urgent action to avert antimicrobial resistance crisis. WHO. 2020. (Available from: https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis; last updated on 2019 April 29; last accessed on 2020 Nov 8)
2. Chris D. CDC spotlights ‘deadly threat’ of antibiotic resistance [Internet]. CIDRAP. 2019. (Available from: https://www.cidrap.umn.edu/news-perspective/2019/11/cdc-spotlights-deadly-threat-antibiotic-resistance; last updated on 2019 Nov 13; accessed on 2020 Nov 8)
Find a GP/Family Doctor and Infectious Disease Specialist in Malaysia, on GetDoc
Find a GP/Family Doctor and Infectious Disease Specialist in Singapore, on GetDoc
by Chang Xian
View all articles by Chang Xian.
