Patients with infections caused by drug-resistant bacteria are at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with non-resistant strains of the same bacteria. Among the commonest rapid growing antibiotic resistance bacteria are E. Coli which cause UTI, Neisseria gonorrhoeae which cause Gonorrhea, Klebsiella pneumonia and Staphlylococcus aureus the commonest causes of severe infections in health facilities and the community generally.
According to WHO: In 2010, an estimated 7% of people starting antiretroviral therapy (ART) in developing countries had drug-resistant HIV. In developed countries, the same figure was 10–20%. Some countries have recently reported levels at or above 15% amongst those starting HIV treatment, and up to 40% among people re-starting treatment. This requires urgent attention.
As of July 2016, resistance to the first-line treatment for P. falciparum malaria (artemisinin-based combination therapies, also known as ACTs) has been confirmed in 5 countries of the Greater Mekong sub-region (Cambodia, the Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam).
WHO estimates that, in 2014, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB), a form of tuberculosis that is resistant to the 2 most powerful anti-TB drugs. Extensively drug-resistant tuberculosis (XDR-TB), a form of tuberculosis that is resistant to at least 4 of the core anti-TB drugs, has been identified in 105 countries. An estimated 9.7% of people with MDR-TB have XDR-TB.
AMR occurs naturally usually through genetic changes but it is facilitated by the inappropriate use of medicines (misuse or overuse), for example using antibiotics for viral infections such as cold or flu, or sharing antibiotics. Low-quality medicines, failure of patients to take full prescribed dose, personal use of drugs without professional prescription, wrong prescriptions and poor infection prevention and control also encourage the development and spread of drug resistance. Lack of government commitment to address these issues, poor surveillance and insufficient of tools to diagnose, treat and prevent also hinder the control of antimicrobial drug resistance.
It threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi. A growing number of infections – such as pneumonia, HIV, Malaria, tuberculosis, gonorrhea, and salmonellosis – are becoming harder to treat and to manage as the antibiotics used to treat them and their management become less effective.
New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death. Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk. This brings achievements of modern medicine at danger.
AMR increases the cost of health care with lengthier stays in hospitals and more intensive care required. Antimicrobial resistance is putting the gains of the Millennium Development Goals at risk and endangers achievement of the Sustainable Development Goals.
Antimicrobial resistant-microbes are found in people, animals, food, and the environment (in water, soil and air). They can spread between people and animals, including from food of animal origin, and from person to person. Poor infection control, inadequate sanitary conditions and inappropriate food-handling encourage the spread of AMR. This makes One Health program (health of both animals, human being and environment under one umbrella) of great importance in our days. This is how anti-microbial resistance can spread;
Since AMR is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control, it is undeniable truth that the whole community is responsible for antimicrobial resistance. Steps should be taken at all levels of society to reduce the impact and limit the spread of resistance from individuals, health professionals to health policy makers.
DID YOU KNOW?
- AMR is an increasingly serious threat to Global public health that requires action across all government sectors and society since it affect global health, food security and development today.
- A failure to address the problem of antibiotic resistance could result in 10 Million deaths per year by 2050, costing $ 100 trillion in economic output worldwide.
- Without effective antibiotics, the success major surgery and cancer chemotherapy would be compromised.
- The cost of health care patients with resistant infections is higher than care for patients with non-resistant infections.
- In 2016, 490000 people developed multi-drug resistance TB globally, and drug resistance is starting to complicate the fight against HIV and malaria as well.
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