Antimicrobial resistance is considered one of the greatest threats to human health and the World Health Organization (WHO) issued a 2014 report on global observations of antimicrobial resistance in which it revealed that antibiotic resistance is no longer a prediction for the future; it is happening right now, across the world.
Antimicrobial resistance is putting at risk the ability to treat even common infections both in the community and hospitals and without an urgent and coordinated action the world is heading towards a post-antibiotic era.
A post-antibiotic era is a truly frightening possibility and one in which common infections and minor injuries, which have been treatable for decades, can and will once again kill. The
UK Prime Minister was quoted saying “..if we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine”
What is antimicrobial resistance?
Antimicrobial resistance is the resistance of a microorganism to an antimicrobial drug that was originally effective for the treatment of infections caused by it. Resistant microorganisms (including bacteria, fungi, viruses and parasites) are therefore ones able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g. antibiotics), antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist, increasing the risk of spread to others.
Whilst the evolution of resistant strains of microorganism is a natural phenomenon that occurs when microorganisms replicate themselves erroneously or when resistant traits are exchanged between them it is well documented that the use and misuse of antimicrobial drugs accelerates the emergence of drug-resistant strains.
Furthermore, poor infection control practices, inadequate sanitary conditions and inappropriate food-handling encourage the further spread of antimicrobial resistance.
- Antimicrobial resistance threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
- It is an increasingly serious threat to global public health that requires action across all government sectors and society.
- Antimicrobial resistance is present in all parts of the world. New resistance mechanisms emerge and spread globally.
- In 2012, WHO reported a gradual increase in resistance to HIV drugs, albeit not reaching critical levels. Since then, further increases in resistance to first-line treatment drugs were reported, which might require using more expensive drugs in the near future.
- In 2013, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB). Extensively drug-resistant tuberculosis (XDR-TB) has been identified in 100 countries. MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB.
- In parts of the Greater Mekong subregion, resistance to the best available treatment for falciparum malaria, artemisinin-based combination therapies (ACTs), has been detected. Spread or emergence of multidrug resistance, including resistance to ACTs, in other regions could jeopardize important recent gains in control of the disease.
- There are high proportions of antibiotic resistance in bacteria that cause common infections (e.g. urinary tract infections, pneumonia, bloodstream infections) in all regions of the world. A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Gram-negative bacteria.
- Treatment failures due to resistance to treatments of last resort for gonorrhoea (third-generation cephalosporins) have been reported from 10 countries. Gonorrhoea may soon become untreatable as no vaccines or new drugs are in development.
- Patients with infections caused by drug-resistant bacteria are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are not resistant.
NEED FOR CONCERTED ACTIONS TO TACKLE ANTIMICROBIAL RESISTANCE
Antimicrobial resistance is a complex problem driven by many interconnected factors. As such, single, isolated interventions have little impact. Coordinated action is required to minimize emergence and spread of antimicrobial resistance.
People can help tackle resistance by:
- hand washing, and avoiding close contact with sick people to prevent transmission of bacterial infections and viral infections such as influenza or rotavirus, and using condoms to prevent the transmission of sexually-transmitted infections;
- getting vaccinated, and keeping vaccinations up to date;
- using antimicrobial drugs only when they are prescribed by a certified health professional;
- completing the full treatment course (which in the case of antiviral drugs may require life-long treatment), even if they feel better;
- never sharing antimicrobial drugs with others or using leftover prescriptions.
Health workers and pharmacists can help tackle resistance by:
- enhancing infection prevention and control in hospitals and clinics;
- only prescribing and dispensing antibiotics when they are truly needed;
- prescribing and dispensing the right antimicrobial drugs to treat the illness.
Policymakers can help tackle resistance by:
- improving monitoring around the extent and causes of resistance;
- strengthening infection control and prevention;
- regulating and promoting appropriate use of medicines;
- making information widely available on the impact of antimicrobial resistance and how the public and health professionals can play their part;
- rewarding innovation and development of new treatment options and other tools.
Policymakers, scientists and industry can help tackle resistance by:
- fostering innovation and research and development of new vaccines, diagnostics, infection treatment options and other tools.
The KRG BioTech team of research scientists, engineers and clinicians are in the process of developing products to assist health services providers in their response to Antimicrobial resistance.
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