Prevention of Antimicrobial Resistance

Introduction:

In the medical world, the development of antibiotics was seen as a victory over infectious diseases. However, it appears that the battle has shifted in favor of the bacteria now that a large number of them have developed resistance to certain antimicrobial treatments. Globally, infectious diseases continue to be a major source of morbidity and mortality. According to the World Health Organization's (WHO) assessment, malaria, HIV/AIDS (human immunodeficiency virus/ acquired immunodeficiency syndrome), diarrheal illnesses, and lower respiratory infections rank among the top 10 causes of morbidity and death.

What Is Antibiotic Resistance?

Antimicrobials are drugs that are used to prevent and cure infections in humans, animals, and plants. They include antibiotics, antiviral drugs, antifungals, and antiparasitics. Drug resistance makes antimicrobial medications, including antibiotics, ineffective and makes treating infections challenging or impossible. This raises the risk of infection spread, serious illness, disability, and death.

Antimicrobial resistance (AMR) is a natural process brought about by pathogen genetic alterations over time. Human activity, particularly the abuse and misuse of antibiotics for the treatment, prevention, or control of illnesses in people, animals, and plants, has increased its appearance and spread.

Antimicrobial resistance results in an increased duration of hospital stay, increased mortality, and higher medical costs. Thus, it is essential to modify the way antimicrobial medicines, especially antibiotics, are prescribed and used. Antibiotic resistance is a major threat, and it will remain so even if new medications are developed unless steps are taken to prevent antibiotic resistance. In addition, behavior changes (vaccination, hygiene) are also important to reduce the spread of infections.

What Are Microorganisms?

Microbes/ microorganisms are defined as organisms that are extremely tiny to see without the use of a microscope. Examples of these species are single-celled eukaryotes (such as amoeba or paramecium) and bacteria, as well as archaea. At times, we also refer to viruses as microorganisms. Microscopic creatures can penetrate the body. Microbes include, for instance:

• Bacteria.

• Virus.

• Fungi.

• Parasites.

Microbes are the most abundant and versatile form of life on Earth, having survived for 3.5 billion years in all kinds of environments.

What Are the Impacts of Antimicrobial Resistance?

Antimicrobial resistance is a global issue that requires efforts from all people, sectors, and nations. New antibiotics and antifungals are in development. However, there is no guarantee that these will be effective against the microorganisms resistant to the current medications. When resistant organisms cause infections, they cannot be treated by the usually used antibiotics or antifungals. As a result, more expensive medications become necessary for treatment.

Furthermore, healthcare costs increase as such infections require a longer treatment duration and hospital stay. Various medical and surgical procedures require perioperative antibiotics and antifungals. With the microorganisms developing resistance, these procedures have become much more dangerous (the medications do not work), and the patient may become susceptible to infections during procedures such as caesarian sections, chemotherapy, and organ transplantations.

What Are the Causes of Antimicrobial Resistance?

1. Innate Resistance: Two types of natural resistance exist in bacteria: intrinsic resistance, which is expressed consistently across the species, and induced resistance, which is expressed to a higher degree only after the bacteria are exposed to an antibiotic. A characteristic that all members of a bacterial species possess is unrelated to horizontal gene transfer and is unaffected by prior antibiotic exposure, which is known as intrinsic resistance.

2. The Acquired Resistance: All of the primary methods by which bacteria acquire genetic material—transposition, conjugation, and transformation, collectively known as horizontal gene transfer (HGT), can result in the collection of genetic material that imposes resistance. In addition, the bacteria may undergo mutations to the chromosomal DNA (deoxyribonucleic acid). The acquisition could be long-term or short-term.

Why Is Antimicrobial Resistance Dangerous?

The resistance to antibiotics and antifungals is rising steeply throughout the world (to dangerously high levels). Every day, new resistance mechanisms develop and spread. This is a threat to the ability to treat common infections. It is becoming increasingly difficult to treat infections such as tuberculosis, pneumonia, gonorrhea, blood poisoning, and food-borne infections. It has become impossible to treat some infections as the antibiotics available have become less effective.

The issue has recently worsened as one can buy antibiotics over the counter without a prescription. In some countries, standard treatment guidelines are not being followed; as a result, healthcare providers over-prescribe antibiotics, further complicating the situation. It is important to acknowledge that without immediate action, the world is heading towards an era where even minor injuries and common infections can kill one again - the post-antibiotic era.

How to Prevent Antimicrobial Resistance?

Antimicrobial resistance is increasing rapidly due to the following:

• Misuse and overuse of antibiotics and antifungals.

• Poor infection control and prevention.

Thus, all levels of society must take preventive measures to limit and reduce the impact of antimicrobial resistance, including

• Individuals.

• Healthcare professionals and the healthcare industry.

• Policymakers.

What Should Be Done by Individuals to Prevent Antimicrobial Resistance?

Every individual can take preventive steps to control and prevent antibiotic resistance. The key preventive measures include:

• Individuals must use antimicrobials only when prescribed by their healthcare provider. Every person should avoid using over-the-counter antibiotics and antifungals.

• Individuals should never demand antibiotics and antifungals if the healthcare providers feel that they do not need them.

• One should always follow their healthcare provider's advice while using antimicrobial medications.

• Sharing or using leftover antibiotics and antifungals should be avoided.

• Every person must ensure that they prevent the spread of infections by maintaining good hygiene, avoiding contact with infected individuals, regularly washing hands, taking vaccinations on time, and practicing safe sex.

• Food must be prepared hygienically. The food must be kept clean and stored at safe temperatures, raw and cooked food must be separated, and the food must be cooked thoroughly. Every person must ensure that safe water and raw food materials are used for food preparation daily.

• One must consume food that has been produced without antibiotic use (for disease prevention and growth promotion in animals).

• One must practice healthy habits around animals. Every individual must clean their hands after feeding, touching, or caring for their pets and other animals. The health of the animals must be ensured, and the veterinarian should be consulted regarding the antimicrobials given to the animals.

What Can Policymakers Do to Prevent Antimicrobial Resistance?

The policymakers must ensure that a robust national plan is in action to control and prevent antimicrobial resistance. They must ensure that the surveillance of antimicrobial-resistant infection improves. Policies and programs must be strengthened and implemented to prevent and control antimicrobial resistance. In addition, the quality and appropriate use and disposal of antimicrobial medications must be regulated and promoted. Most importantly, policymakers must ensure that the information about the impact of antimicrobial resistance is available to all (the public).

How Can Healthcare Professionals Contribute to Preventing Antimicrobial Resistance?

Healthcare professionals must take steps to control and prevent antimicrobial resistance. The key measures include:

• Ensuring that their instruments, hands, and hospital or clinic environment are clean.

• Prescribing and dispensing antibiotics only when needed according to the standard guidelines.

• Reporting antimicrobial resistance (infections that are difficult to treat with the available medications) to surveillance teams.

• Keeping their patients informed about the correct way to use antibiotics and antifungals, antimicrobial resistance, and the dangers of misusing or overusing antimicrobials.

• Advising their patients regarding measures to prevent infections, such as vaccination, safer sex, regular hand washing, and covering mouth and nose while sneezing.

In addition, the healthcare industry must invest in research and development of new diagnostic tools to identify antimicrobial resistance, new antibiotics and antifungals, vaccines, and other tools to prevent and control infections.

Conclusion:

Tackling antimicrobial resistance must be a high priority for all. The World Health Organization (WHO) has put forth global action plans to prevent and control antimicrobial resistance. Ensuring that all infectious diseases can be treated efficiently with effective and safe medications is vital. To prevent antimicrobial resistance, everyone's awareness and understanding of antimicrobial resistance must be improved. Surveillance and research should be strengthened to prevent antimicrobial resistance. The usage of antimicrobial medications must be optimized and strictly monitored. In addition, the incidence of infections must also be controlled.