Antimicrobial Resistance

By: Navya Sharma

Definition

“Antimicrobial resistance is resistance of a microorganism to an antimicrobial drug that was originally effective for treatment of infections caused by it." ~ World Health Organization

Causes and Contributors

  • Insanitary conditions, handling food inappropriately, and poor infection control practices
  • Misuse of antibacterial drugs
  • When someone takes antibiotics, feels better, and doesn’t finish it, it increases antimicrobial resistance, as some of the microbe may still be left behind, therefore the sickness might come back and antimicrobial resistance can develop from generation to generation
  • The microbe can also mutate/evolve to develop resistance over time such as super bugs and microbes can pass it on to the next generation through reproduction
  • Animals carry bacteria inside their guts, it kills most of the bacteria but not all of it. The animals are killed and that bacteria can contaminate the meat and meat around it. And when you eat it or touch it, you get the resistant bacteria and you can get sick, make your recovery time longer or in severe cases even die
  • Antibiotics are also used to increase the growth of animals
  • When an animal poops, bacteria can also get into the sewage system and contaminate it. Making our water supply contaminated and making people sick

Effects

  • People with infections from resistant microbes have a lower chance to get well with regular treatments which might make the patient’s sickness longer and the patient will have a higher risk of death
  • It reduces effectiveness of the treatment and increase the spread of antimicrobial resistance microbes to others
  • Cost of health care increases as more expensive treatments become mandatory
  • Organ transplantation, cancer chemo theory, and major surgery would be effected, as these operations need antibiotics to prevent infection

Super Bug

  • Bacteria that can’t be killed by multiple drug

  • Doctors usually call it a : “ multidrug-resistant bacteria” (WebMD) – this is because super bugs aren’t resistant to all antibiotics. A superbug is defined as bacteria that can’t be killed using two or more antibiotics.

  • Misusing antibiotics and visiting the hospital a lot gives a higher risk of catching

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Microevolution

  • Antimicrobial Resistance is an example of microevolution as there are changes in gene frequencies (from a normal microbe gene to a resistance gene) in a population from one generation to another
  • Natural selection is shown by antimicrobial resistance as bacteria evolves its genes to adapt/sustain in its environment.
  • Mutation may also occur to the bacteria making it antimicrobial resistance and it could even develop into a superbug
  • Antimicrobial resistance is an example directional selection because bacteria evolves over time and the phenotype for antimicrobial resistance is more favored
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Stakeholder Perspectives

Public

  • Price of health care increases, because of expensive treatments
  • Higher risk of death

Antimicrobial Resistance Research Groups

  • Research groups in the past and now try to do research and develop a way to stop antimicrobial resistance but, many research groups stopped doing that because they don't get enough funding

Doctors

  • Have to use more toxic drugs to kill superbugs
  • Have to keep the hospital as clean as they can to stop the spread of superbugs, even though, right now they do not know how, they must find a way to develop it
  • More patients, longer working hours
  • Higher risk of getting a superbug themselves

Changes in the Environment

Bacteria likes to thrive in warmer environments. Research has shown that infections increase from winter to summer. This means that if the earth's average temperature got hotter, then there would be a higher risk in infection and disease. Therefore, climate change also has an impact on antimicrobial resistance because if there are more infections, then people will take more antibiotics, increasing antimicrobial resistance.
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Local v.s. Global Impacts

Local

  1. Someone gets a resistant bacteria or superbug
  2. It gets worse
  3. It spreads throughout the hospital and eventually into the community


Global

  1. Someone gets a resistant bacteria or superbug in another country
  2. They go to their country to get it treated
  3. As it gets worse, it spreads
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Evidence of Evolution

Molecular Evidence

Ancient microbes have show antimicrobial resistance. DNA from 30,000 year old Beringian permafrost sediments that are resistant to β-lactam, tetracycline and glycopeptide antibiotics. These microbes share a similar element that cause resistance in microbes today.


Today in the modern world, we are seeing more and more cases of antibiotic-resistant microbes and superbugs. This proves that the bacteria is evolving and getting stronger.

Resistance is found all over the world nowadays.

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Decrease and Prevention

Public

  • Wash your hands
  • Don't get in close contact with sick people
  • Get vaccinations
  • Don't share antimicrobial drugs or use old ones
  • Take antimicrobial drugs only when prescribed by a professional and if necessary take the necessary amount

Doctors

  • Can make hospitals safer by following sanitary procedures
  • Give antimicrobial drugs to patients only when it's necessary

Policymakers

  • Let people know about antimicrobial resistance and how to prevent it
  • Regulating the proper use medicine

Policymakers, Scientists, and Industries

  • Research and make new medicines and vaccinations

Facts

  • "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."
  • "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."
  • "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."

World Health Organization ~

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