Antimicrobial Resistance – Definition, Causes & Types
May 17, 2023, 16:45 IST
A growing hazard to public health, antimicrobial resistance (AMR) has drawn attention from all across the world. When bacteria, viruses, fungi, parasites, and other microbes become resistant to antibiotics and other antimicrobial medications used to treat infections, AMR occurs. As a result, treating and managing infections becomes challenging, which raises morbidity, mortality, and healthcare expenses. AMR is dangerous for anybody with a compromised immune system, including the elderly and those with chronic illnesses, and can afflict anyone, anywhere, at any time.
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What Is Antimicrobial Resistance?
Antimicrobial resistance (AMR) is the ability of microorganisms, such as bacteria, viruses, fungi, and parasites, to resist the effects of antimicrobial drugs that are used to treat infections. These drugs include antibiotics, antivirals, antifungals, and antiparasitics. AMR occurs when genetic changes in the microorganisms make them less susceptible to the drugs that would normally kill them, leading to the emergence of drug-resistant strains.
AMR is a growing global public health concern, as it makes it more difficult to control the spread of infectious diseases and treat infections, leading to increased morbidity, mortality, and healthcare costs. It also poses a significant threat to global health security, as the spread of resistant strains can quickly become an international problem. To effectively address AMR, a comprehensive, multi-faceted approach is needed, including reducing the overuse and misuse of antibiotics, investing in research and development, improving infection prevention and control practices, promoting international cooperation, and raising public awareness.
What Can Cause Antimicrobial Resistance?
Antimicrobial resistance (AMR) is caused by a complex interplay of factors, including the overuse and misuse of antibiotics, poor infection prevention and control practices, and a lack of investment in research and development of new antibiotics. The following are some of the key causes of AMR:
- Overuse and Misuse of Antibiotics
One of the main causes of AMR is the overuse and misuse of antibiotics. This can occur when antibiotics are prescribed for conditions that are not caused by bacteria, such as the common cold, or when antibiotics are used unnecessarily, such as for mild infections that would resolve on their own. The overuse and misuse of antibiotics leads to the selection and spread of resistant bacteria.
- Poor Infection Prevention and Control Practices
Poor infection prevention and control practices, such as inadequate hand hygiene, can also contribute to the development of AMR. This is because these practices can lead to the spread of infections, which can increase the risk of exposure to and the development of resistant bacteria.
- Lack of Investment in Research and Development
A lack of investment in research and development of new antibiotics is also a major cause of AMR. This is because new antibiotics are needed to combat the emergence of resistant strains and to ensure that effective treatments are available to combat infections.
- Widespread use of antibiotics in agriculture and aquaculture
The widespread use of antibiotics in agriculture and aquaculture, particularly for the prevention and treatment of diseases in livestock and fish, can contribute to the development of AMR. This is because these practices can lead to the selection and spread of resistant bacteria.
- International Spread of Resistant Strains
The international spread of resistant strains is another major cause of AMR. This can occur through international travel and the trade of goods and animals, which can lead to the spread of resistant strains from one country to another.
- Selective Pressure
When exposed to antimicrobial agents, microbes either die or survive and replicate if they possess resistance genes. This leads to the dominance of these resistant microbes in the population.
- Mutation
Microbes reproduce rapidly, with cycles of division occurring every few hours. This rapid evolution allows them to adapt to new environmental conditions, and mutations may arise during division. Some of these mutations confer resistance to antimicrobial agents.
- Gene Transfer
Gene transfer refers to the transfer of genetic material from one organism to another. In the context of antimicrobial resistance, gene transfer plays a crucial role in the spread of antibiotic resistance genes among different microorganisms. This can occur through mechanisms such as horizontal gene transfer, where resistance genes are transferred directly from one bacteria to another, or vertical gene transfer, where resistance genes are passed from parent to offspring. This results in the dissemination of antibiotic resistance among bacterial populations, leading to the development of antibiotic-resistant infections.
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Examples of Antimicrobial Resistance
- Tuberculosis (TB)
TB was a significant concern before the advent of antibiotics, but drug-resistant forms of the disease have recently emerged. These forms of TB do not respond to standard antibiotic treatments and can be extremely difficult to treat, with poor management potentially leading to fatal outcomes.
- Gonorrhoea
This sexually transmitted disease is caused by bacteria, and drug-resistant cases have become increasingly common.
- Escherichia coli
These bacteria are responsible for foodborne diseases and infections in the urinary tract, with cases of antibiotic resistance increasing rapidly.
- Malaria
In many parts of the world, drug-resistant malaria parasites have developed, making them resistant to antimalarial drugs. To overcome this, alternatives such as viruses that consume bacteria, vaccines for the disease, and the use of probiotics to restore gut microbes are being developed.
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Impact of Antimicrobial Resistance
Antimicrobial resistance (AMR) has a significant impact on public health and global health security, with far-reaching consequences for individuals, communities, and societies. Some of the key impacts of AMR include:
- Increased Morbidity and Mortality
AMR leads to an increase in morbidity and mortality, as infections caused by resistant strains are more difficult to treat and control. This can result in longer hospital stays, increased use of more toxic and expensive drugs, and a higher risk of death.
- Disruptions to Healthcare Services
AMR can cause disruptions to healthcare services, as hospitals and other healthcare facilities are faced with increasing numbers of patients with resistant infections. This can lead to overcrowding and a reduction in the availability of beds, higher healthcare costs as well as increased pressure on healthcare workers.
- Negative Impacts on Agriculture and Aquaculture
The spread of resistant bacteria in agriculture and aquaculture can have negative impacts on food production and food security, as well as on the health and welfare of livestock and fish.
- Reduced Efficacy of Medical Procedures
AMR can also reduce the efficacy of medical procedures, such as surgeries and chemotherapy, as these procedures rely on the use of antibiotics to prevent and control infections.
- Negative Impacts on Global Health Security
The international spread of resistant strains poses a significant threat to global health security, as it can rapidly become an international problem, with far-reaching consequences for public health and global health security.
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Strategies to Address Antimicrobial Resistance
Addressing antimicrobial resistance (AMR) requires a comprehensive, multi-faceted approach, involving multiple stakeholders and incorporating a range of strategies and interventions. Some of the key strategies to address AMR include:
- Reducing the Overuse and Misuse of Antibiotics
One of the key strategies to address AMR is to reduce the overuse and misuse of antibiotics. This can be achieved through promoting the appropriate use of antibiotics, including reducing the prescription of antibiotics for conditions that are not caused by bacteria, and improving the use of antibiotics in hospitals and other healthcare facilities.
- Improving Infection Prevention and Control Practices
Improving infection prevention and control practices is another key strategy to address AMR. This includes promoting hand hygiene, implementing infection control measures, and improving vaccination coverage.
- Investing in Research and Development
Investing in research and development is critical to addressing AMR, as it is essential to develop new antibiotics and alternative treatments for infections. This includes supporting basic research into the mechanisms of AMR and the development of new treatments and vaccines.
- Promoting International Cooperation
Promoting international cooperation is critical to addressing AMR, as the spread of resistant strains is a global problem that requires a global solution. This includes sharing data and expertise, supporting research and development initiatives, and working together to implement effective policies and interventions.
- Raising Public Awareness: Raising public awareness
Raising awareness in the general public is an important strategy to address AMR, as it is essential to educate individuals, communities, and healthcare providers about the risks associated with AMR and the importance of reducing the overuse and misuse of antibiotics.
- Strengthening Surveillance and Monitoring Systems
Strengthening surveillance and monitoring systems is critical to tracking the spread of resistant strains and to detecting new outbreaks and trends. This includes improving the collection and analysis of data, as well as strengthening laboratory capacity and expertise.
- Regulating the Agricultural and Aquaculture Use of Antibiotics
Keeping a check on and controlling the agricultural and aquaculture use of antibiotics is also a key strategy to address AMR, as these practices can contribute to the development of resistant bacteria. This includes promoting the responsible use of antibiotics, reducing the use of antibiotics for growth promotion, and improving animal husbandry practices.
Antimicrobial Resistance Related: FAQs
Q1. What is antimicrobial resistance (AMR)?
Ans. AMR is the ability of bacteria, viruses, fungi, and parasites to resist the effects of antimicrobial drugs, making it more difficult or even impossible to treat infections.
Q2. What are the causes of AMR?
Ans. AMR is caused by the overuse and misuse of antimicrobial drugs, as well as poor infection prevention and control practices. This allows resistant strains of bacteria to proliferate and spread, making it more difficult to treat infections.
Q3. What are the impacts of AMR on public health and global health security?
Ans. AMR has a significant impact on public health and global health security, leading to an increase in morbidity and mortality, higher healthcare costs, disruptions to healthcare services, reduced efficacy of medical procedures, and negative impacts on agriculture and aquaculture.
Q4. What are the strategies to address AMR?
Ans. Addressing AMR requires a comprehensive, multi-faceted approach, including reducing the overuse and misuse of antibiotics, improving infection prevention and control practices, investing in research and development, promoting international cooperation, raising public awareness, strengthening surveillance and monitoring systems, and regulating the agricultural and aquaculture use of antibiotics.
