Written By: Jyothsna Krishnakumaar
Introduction
Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. Antibiotic resistance in bacteria is starting to become a growing concern in medical science, which specialists think are mostly likely caused by the use/overuse of antibiotics. We use antibiotics to kill the growth of bacteria, while treating infections and preventing disease spread as well. However, the more we use these drugs, the more chances bacteria have to adapt and develop stronger resistance towards these antibiotics we use in our daily life. This situation is becoming a much more serious threat to health worldwide.
The Causes of Antibiotic Resistance
The main reason for antibiotic resistance in bacteria is because of antibiotic misuse & its overuse. When we use these antibiotics, we use it to kill vulnerable bacteria, but the resistant ones still have the strength to survive. The bacteria that survive the antibiotics not only multiply but also pass on their resistant traits to their offspring. This makes treating future bacterial infections caused by these bacteria more challenging. Overuse and misuse of antibiotics in humans, animals, and plants end up speeding this process up, which can lead to more resistance and to the start of an evolution of antibiotic-resistant bacteria.
Antibiotic resistance occurs when bacteria evolve in response to the use of these drugs. The Bacteria that were once able to be eliminated using these antibiotics, now have started to evolve to withstand its effects, which doesn't affect the bacteria anymore like it used to. This evolutionary process of this is driven by the genetic changes that can occur naturally over time such as bacteria spreading their resistant traits to their offspring, but this evolution has been greatly affected and sped up by the misusing and overusing of these antibiotics.
Figure 1. Researchers have warned of resistant bacteria evolving & showing resistance to antibiotics, challenging modern medicine's effectiveness against these bacterial infections.
Contributors to Antibiotic Resistance
Agriculture- In agriculture, there is a large amount of use of livestock. Antibiotics are used in these livestock to promote growth, prevent diseases, and disease treatment. These antibiotics are commonly used in swine production throughout the United States and in various parts around the world. This tradition causes more bacteria becoming resistant, which can spread to humans through food, contact, and the environment.
Environment- In our environment, there is a lot of contamination caused by humans due to their improper way to dispose of antibiotics, water, and pharmaceutical waste. These Antibiotic-resistant bacteria can live through these and spread through environmental contamination, which in result creates more bacteria becoming resistant, which can spread to humans through water, soil, and air.
Human Medicine- In human medicine, A problem regarding antibiotics has started to spur, which is when antibiotics have been prescribed unnecessarily for viral infections, even though doctors know they are ineffective. This happens because patients expect antibiotics, and the doctors may feel pressured to prescribe them antibiotics, despite knowing they won't work against viruses so that the patient can feel secure.
These prescriptions are unnecessary for infections that can easily be gone, the mismatch between patient expectations and medical necessity can lead to overprescribing and improper disposal of medicine which lead to antibiotic resistance in bacteria. Moreover, when patients stop taking their antibiotics before finishing the full course, it leads to bacteria surviving & becoming much more resistant than they were before, and continuing on through their offspring. The general idea is that surviving bacteria can develop resistance to the antibiotic, making future infections harder to treat with medicine.
Global Impact of the Antibiotic Resistant Bacteria
The worldwide impact of antibiotic resistance is a serious health crisis affecting people in our world, no matter where they live, or even their different income. Antibiotic-resistant infections have been spreading more easily due to ineffective medicine. This has made it harder to control the bacterial diseases that have started to outbreak in communities and places with healthcare.
These infections are often more severe and much harder to treat, which can end up to longer illnesses unresolved with medicine, more patient complications, and there is a higher percent of higher risk of long-term disability for those affected by these infections.
The death rates for these antibiotic-resistant infections are becoming higher which could become an alert worldwide, and in some cases, there could be a possibility of no effective treatment being available to treat these infections, which could be fatal. The economic impact has been impacting healthcare costs. These costs have been rising due to more care needed to these patients due to no effective treatment, longer hospital stays, and the need for expensive medications.
Figure 2. Global Impact of Antimicrobial Resistance on Human Health
Prevention of these Bacteria
Maintaining good hygiene & practices to control infections/diseases can reduce spread of these antibiotic-resistant bacteria. Installing strict infection control measures in places, such as restaurants, school, work, and hospitals can help prevent the spread of resistant infections in hospitals and clinics. Vaccines can prevent infections such as getting your flu shots. Regular hand washing and using proper sanitation practices greatly help reduce the spread of the antibiotic-resistant bacteria.
Properly disposing antibiotics & having proper waste management greatly helps reduce environmental contamination. By doing this, antibiotics that are disposed of correctly, prevent their way into the environment, where they can contribute to the development of antibiotic-resistant bacteria. This also correlates to the use of antibiotics in agriculture that should be watched very carefully. Using these types of practices, such as proper hygiene, disposing of antibiotics properly, and agriculture, practices such as these, should have proper disposal in places such as pharmaceutical manufacturing, healthcare facilities, and agricultural sources is essential for minimizing the release of both antibiotics and resistant bacteria. The common use of Antibiotics in our agriculture is for livestock, and should be with caution. The use of these antibiotics is to promote growth and to cure the livestock of any diseases. Additionally ,using these types of practices, such as proper hygiene, disposal of antibiotics properly, and agriculture, practices such as these should have proper disposal in places such as pharmaceutical manufacturing, hospital care, and agricultural lands. This is critical for reducing both antibiotics & resistant bacteria. These precautions and practices can help us protect the public & our ecosystems because it reduces the spread of contamination.
How to Know if you have Antibiotic Resistant Bacteria
To determine if you have antibiotic-resistant bacteria, your doctor would request a blood test to detect sepsis ( a serious condition in which the body responds improperly to an infection). Specialists in a laboratory expose the bacteria in the sample to different antibiotics. If the bacteria continue to grow, they are thought to be resistant to the medications.
Figure 3. Illustration of genetic mutations in bacteria leading to antibiotic resistance.
Through mutation and selection, bacteria can develop defense mechanisms against antibiotics. For example, some bacteria have developed biochemical “pumps” that can remove an antibiotic before it reaches its target, while others have evolved to produce enzymes to inactivate the antibiotic. Bacteria share the genes responsible for antibiotic resistance through circular pieces of DNA called plasmids, but the process of their transfer in the host is complex. New findings in mSphere suggest that the genetic makeup of the host organism can influence the transfer of plasmids. Antibiotic resistance can be achieved through multiple dimensions of the mutation rate. This includes the horizontal acquisition of resistance genes, carried by plasmids or transposons, recombination of foreign DNA into the chromosome, or mutations in different chromosomal loci. The mutation either disabled or counteracts the antibiotic so the bacteria can live in the presence of antibiotics. Some of the commonly reported antibiotic resistance genes in healthcare environments include mecA, blaTEM, blaSHV, blaOXA, tetA, tetO, tetS, tetQ, tetW, qnrS, sul1, and ermB (Zhang et al., 2009; Rodriguez-Mozaz et al., 2015).As β-lactamases are the biggest class of antibiotic resistance gene category and contribute to almost 50% of all known antibiotic resistance incidences, we as the first version, has assembled the all β-lactamase genes in bacteria.The mutation either disabled or counteracts the antibiotic so the bacteria can live in the presence of antibiotics.
Conclusion
The evolution of antibiotic resistance in bacteria has become a challenge to our world's modern medicine and public's global health. Through practices such as overuse & misuse of antibiotics in clinical and agricultural settings, genetic mutation, having no proper disposal of pharmaceutical wastes, and no proper hygiene. This calls for the urgent need for more immediate strategies to address this issue. Effective measures include investing the money we throw to waste by misusing antibiotics into new research that develop new treatments for positive patient outcomes. By using the efforts and putting it into funding new research we used in overprescribing these ineffective antibiotics we can use them in these critical areas, and we can ensure that our healthcare systems remain adaptable and continue to provide effective treatments for future generations and get rid of future generations of these antimicrobial resistant bacteria (AMR).
Bibliography
“Antibiotic Resistance: What Is It, Complications & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/articles/21655-antibiotic-resistance. Accessed 19 July 2024.
“Antimicrobial resistance.” World Health Organization (WHO), 21 November 2023, http://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance. Accessed 19 July 2024.
“Causes of Antimicrobial (Drug) Resistance | NIAID: National Institute of Allergy and Infectious Diseases.” National Institute of Allergy and Infectious Diseases (NIAID), 21 December 2011, https://www.niaid.nih.gov/research/antimicrobial-resistance-causes. Accessed 19 July 2024.
“What causes AMR?” Antimicrobial resistance, 31 October 2022, http://www.amr.gov.au/about-amr/what-causes-amr. Accessed 19 July 2024.
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