Discover essential insights on antimicrobial resistance, including prevention strategies, global challenges, and innovative solutions.
What Is Antimicrobial Resistance (AMR)?
Antimicrobial resistance is a phenomenon wherein microorganisms, including bacteria, viruses, fungi, and parasites, develop the ability to withstand the effects of antimicrobial drugs (1). Antimicrobial resistance (AMR) poses a significant challenge to effectively preventing and treating a widening spectrum of infections caused by various microorganisms (2).
Antimicrobials including antibiotics, antivirals, antifungals, and antiparasitics, are essential for treating various infections in humans and animals. However, the emergence of resistance undermines their efficacy, rendering once-effective treatments ineffective. In this blog post, we will explore the causes and consequences of antimicrobial resistance, and the strategies being undertaken to tackle this global health threat.
Differentiating Between Antibiotic and Antimicrobial Resistance
While antibiotics specifically target bacteria, antimicrobial resistance encompasses resistance to a broader range of microorganisms, including viruses, fungi, and parasites. The resistance mechanisms may vary depending on the type of microorganism and the specific antimicrobial agent involved.
The Science Behind AMR: Resistance Evolution in Microorganisms
The development of antimicrobial resistance occurs through various mechanisms and understanding the difference between intrinsic and acquired resistance is crucial in combating antimicrobial resistance. Inherent resistance refers to certain organisms being naturally unaffected by antimicrobial drugs due to their specific characteristics.
For example, Gram-negative bacteria have an outer membrane that blocks the action of drugs like vancomycin, making them inherently resistant. This trait is inherent to these bacteria and cannot be changed. Acquired resistance, on the other hand, develops over time when previously susceptible organisms adapt to antibiotics (3). This adaptation occurs through various mechanisms, including genetic mutations and horizontal gene transfer (4).
When exposed to antimicrobial drugs, microbes may undergo genetic changes that enable them to evade the drugs’ effects. Additionally, bacteria can acquire resistance genes from other bacteria, further enhancing their ability to resist antimicrobials.
Why Is Antimicrobial Resistance A Problem?
Antimicrobial resistance poses multifaceted challenges with significant implications for public health, healthcare institutions, and global economies.
Treatment Failures and Increased Mortality Rates
The rise of antimicrobial resistance leads to treatment failures, prolonged illnesses, and increased mortality rates (5). Patients infected with resistant pathogens may experience delays in receiving effective treatment, leading to poorer clinical outcomes and higher mortality rates. Healthcare institutions bear the brunt of these challenges, grappling with the burden of managing resistant infections and implementing strategies to contain their spread.
Re-emergence of Previously Controlled Diseases
Antimicrobial resistance can facilitate the re-emergence of diseases that were once under control or thought to be eradicated. For example, tuberculosis (TB), a bacterial infection, has seen a resurgence in some regions due to the emergence of drug-resistant strains (6). This resurgence underscores the importance of ongoing surveillance and control efforts to prevent the spread of resistant pathogens.
The Cost of AMR to Global Healthcare Systems
The economic impact of antimicrobial resistance is staggering, affecting healthcare systems worldwide. The World Bank has warned that, by 2050, drug-resistant infections could cause as much global economic damage as the 2008 financial crisis (7). The costs associated with treating resistant infections, managing complications, and implementing infection control measures place a significant strain on healthcare budgets and resources.
What Causes Antimicrobial Resistance?
Several factors contribute to the development and spread of antimicrobial resistance, including:
Overuse and Misuse of Antibiotics in Medicine
The overuse and misuse of antibiotics in human and veterinary medicine contribute to the selective pressure driving the emergence of resistant bacteria (5). Factors such as prescribing antibiotics for viral infections, incomplete antibiotic treatment courses, and over-prescription by healthcare professionals contribute to the proliferation of resistant strains.
The Lack of New Antibiotics
The pipeline for new antibiotic development has significantly slowed down, hampered by scientific, regulatory, and economic challenges (4). As a result, the rate of antimicrobial resistance outpaces the introduction of new antibiotics, narrowing the window of effective treatment options and exacerbating the problem.
Contribution of Global Travel and Trade to AMR Spread
Globalization has facilitated the rapid spread of resistant microbes through international travel and trade (8). Resistant bacteria can hitch a ride across continents, disseminating through different populations and environments. Moreover, the lack of uniform global standards for antibiotic use in healthcare and agriculture further complicates efforts to combat antimicrobial resistance.
What Is Being Done To Solve The Problem Of Antimicrobial Resistance?
Addressing antimicrobial resistance requires a comprehensive and coordinated approach involving multiple stakeholders and strategies.
World Health Organisation’s Global Action Plan On Antimicrobial Resistance
The World Health Organization (WHO) has developed a Global Action Plan on Antimicrobial Resistance, which outlines a strategic framework for combating AMR (9). The plan emphasizes the need for multisectoral collaboration, surveillance and monitoring, antimicrobial stewardship, research and innovation, and public education and awareness.
Antimicrobial Stewardship Programs in Healthcare Organisations
Healthcare institutions, including hospitals and clinics, are implementing antimicrobial stewardship programs to optimize antimicrobial use and combat resistance (10). These programs involve policies and protocols aimed at promoting appropriate prescribing, reducing unnecessary antibiotic use, and preventing the spread of resistant infections within healthcare settings.
Development of New Personal Protection Equipment (PPE) and antimicrobial technologies
Innovations in personal protection equipment (PPE) and antimicrobial technologies offer promising solutions for preventing the spread of resistant pathogens. An antimicrobial is commonly defined as a substance capable of killing, resisting, or inhibiting the growth of microorganisms. An antimicrobial agent, whether natural or synthesized, is a substance that effectively kills or inhibits the growth of microbes.
Hygenica is a leading infection prevention technology company based in the UK, and our team of scientists are developing advanced antimicrobial technologies and agents designed to minimize the transmission of infectious agents and reduce the risk of antimicrobial resistance (8). These modern solutions play a crucial role in infection prevention and control efforts, particularly in healthcare and other high-risk settings.
Final Thoughts
Antimicrobial resistance poses a formidable challenge to global public health, with far-reaching implications for healthcare, economies, and ecosystems. Addressing this complex issue requires collective action and sustained investment in surveillance, research, innovation, and education. By implementing evidence-based strategies, promoting responsible antimicrobial use, and fostering international cooperation, we can work towards preserving the effectiveness of antimicrobial drugs and safeguarding the health and well-being of future generations.
References:
Sørensen, S. J., & Sørensen, A. H. (2005). Antimicrobial agents. In Encyclopedia of Chemistry (pp. 104-109). Elsevier.
World Health Organization. (n.d.). Antimicrobial resistance. Retrieved from https://www.who.int/health-topics/antimicrobial-resistance
https://www.sciencedirect.com/topics/chemistry/antimicrobial-agent
Sardar, M., & Pal, S. (2020). Antimicrobials. In Encyclopedia of Neuroscience (pp. 169-173). Elsevier. https://www.sciencedirect.com/topics/neuroscience/antimicrobials
United Kingdom Health Security Agency. (2021, November 17). What is antimicrobial resistance and why do we need to take action against it? Retrieved from https://ukhsa.blog.gov.uk/2021/11/17/what-is-antimicrobial-resistance-and-why-do-we-need-to-take-action-against-it/
World Health Organization. (n.d.). Antimicrobial resistance. Retrieved from https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
World Bank. (2016). Drug-resistant infections: A threat to our economic future (No. 107743). World Bank. Retrieved from https://www.worldbank.org/en/topic/health/publication/drug-resistant-infections-a-threat-to-our-economic-future
Biocote. (n.d.). What is an antimicrobial? Retrieved from https://www.biocote.com/what-is-antimicrobial-technology-explained/what-is-an-antimicrobial/
World Health Organization Regional Office for the Eastern Mediterranean. (n.d.). Global action plan on antimicrobial resistance. Retrieved from https://www.emro.who.int/health-topics/drug-resistance/global-action-plan.html
