Just as humans have been evolving over the centuries, microbes, fungi, parasites, and viruses which can engender various infections have been evolving over the past few decades. What used to be relatively simple ailments have become resistant to treatment leading to grave complications, and even death in some cases. This occurs when the microorganisms evolve in such a way that medications, chemicals, and other means to counteract them and prevent infection become ineffective, and the resistant microbes keep multiplying despite therapeutic levels of antibiotics in the system.
Some drug-resistant infections include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA), extended-spectrum beta-lactamase (ESBL), vancomycin-resistant Enterococcus (VRE), multidrug-resistant A. baumannii (MRAB).
Hobson’s choice for doctors:
Lack of adequate information makes many doctors prescribe antibiotics for influenza, viral fevers, and common colds to prevent secondary infections. Unfortunately, it eventually leads to antibiotic resistance while undermining the body’s natural ability to fight infection. It really is a Hobson’s choice for the doctors who risk being accused of carelessness — or even professional negligence — if they don’t prescribe antibiotics, and the patient succumbs to secondary infection.
An overview suggests that overuse of certain antibiotics and of broad-spectrum antibiotics could be at the root of antimicrobial resistance (AMR) globally. Add to that, the propensity of many patients to stop taking their medicines as soon as they feel better. This makes the bacteria drug-resistant as they develop immunity to the antibiotic. Does it affect you? Yes, it does. An estimate by the US Center for Disease Control and Prevention (CDC) postulated that annually as many as two million Americans are infected with antibiotic-resistant infections resulting in as many as 23,000 deaths. Dutch research indicates that this resistance does not seem to be reversible, and usually becomes permanent in the long term. Bacteria that are resistant to many antibiotics are known as multi-resistant organisms (MRO).
A study commissioned by UK Prime Minister, David Cameron, in 2014 disclosed that as many as 70,000 lives are lost annually around the world to drug resistance in cases of TB, malaria, HIV/AIDS, and other bacterial infections which had begun coming under control. In the US and Europe, as many as 50,000 people die from AMR. The dreadful prospect of even routine surgeries and minor infections becoming life-threatening is looming over all of us. The horrendous prognosis is that by the year 2050, one person could die in every three seconds due to AMR. The same study projected that by 2050, the cost of AMR could be as high as $100 trillion annually.
The World Health Organization (WHO) published a “Global Report on Surveillance of AMR” in 2014 which had collected and presented data on the extent of AMR worldwide as well as identified where gaps exist. WHO had outlined a Global Strategy for Containment of Antimicrobial Resistance in 2001, which created a framework to diminish the spread of antimicrobial-resistant microorganisms while slackening its emergence.
Some of the proactive actions which countries should take through their healthcare providers and facilities include infection prevention and control; wiser — and more restrained — use of antibiotics in hospitals and in the home; encourage the development of newer vaccines and medicines; monitor the impact of interventions; and understand AMR trends.
Few people realize it, but injecting antibiotics into domesticated cattle and poultry can have dangerous implications for anyone drinking any milk other than soy milk, or eating any dairy product, eggs, or meat — chicken, duck, lamb, mutton, beef. Barring the vegans, just everybody could be exposed to food which might have antibiotic-resistant microbes or parasites. Laboratory tests have indicated the presence of pus cells and other contaminants in milk drawn from cows and buffaloes in modern dairies. The use of antibiotics in livestock has contributed largely to the spread of AMR.
Crops grown on soil are the other unsuspected source. The soil is a reservoir of antibiotic resistance genes since most antibiotics are derived from soil microorganisms that are intrinsically resistant to the antibiotics produced. Therefore, cereals, fruits, and vegetables become sources for dissemination of antibiotic-resistant bacteria.
Better animal farming methods which focus on cleanliness, hygiene, and non-medicinal care would reduce the susceptibility of cattle to infections. Research to find newer vaccines to prevent many ailments would serve as a starting point to counter AMR as it would reduce dependence on antibiotics. Research conducted by Harvard and MIT researchers on how bacteria develop resistance has indicated that use of antibiotics lowers the body’s natural immune responses, thereby making the patient more susceptible to infections in the future.
Patients and doctors have to unite to prevent the scenario from getting worse.