Medilink Consultant clinic

Online Consultation

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Explore the growing concern of superbugs and their impact on health with Meri Sehat. Understand preventive measures for a healthier future.

Superbugs, The Scary Epidemic

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

Introduction

Antimicrobial is a term used to describe drugs meant for the treatment of bacterial, fungal, viral, protozoan, and parasitic infections. It includes antibiotics, antivirals, antifungals and antiparasitic drugs. 
&nbsp;

The first antibiotic, penicillin was discovered by Sir Alexander Fleming in 1928, from the culture filtrate of a fungus<a href="#accordion">[1]</a>&nbsp;.15 years later, American microbiologist Selman Waksman and his colleagues termed it &ldquo;antibiotic&rdquo;. Since then, antibiotics have saved millions of lives.&nbsp; 
&nbsp;

Although antibiotics weren&rsquo;t introduced into clinical practice till the middle of the last century, the treatment of serious infections using antibiotics has been well-documented in different parts of the world since ancient times, including Egypt and China. 
&nbsp;

Penicillin, in particular, was successfully administered among World War II soldiers to control bacterial infections. By the 1950s, the world witnessed a strange phenomenon: penicillin resistance. The medicines weren&rsquo;t effective anymore! It not only became a major clinical concern, but also threatened the advances made in the previous decades<a href="#accordion">[2]</a>.&nbsp; 
&nbsp;

After a decade, beta-lactam antibiotics were discovered, which restored confidence in antibiotics. Soon after, the first case of Methicillin-resistant Staphylococcus aureus (MRSA) was reported in the United Kingdom in 1962 and United States in 1968<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

Unfortunately, the resistance is now seen with nearly all antibiotics developed over the years.&nbsp;&nbsp;

A few years into the MRSA outbreak, researchers developed vancomycin, which was introduced into clinical practice in 1972<a href="#accordion">[3]</a>. It was used for the treatment of both S. aureus and coagulase-negative staphylococci.&nbsp; 
&nbsp;

Since it had been difficult to induce vancomycin resistance in a clinical setting, it was deemed highly unlikely. However, it wasn&rsquo;t long before cases of vancomycin resistance were also reported in 1979 and 1983<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

Thereafter, the pharmaceutical industry introduced new antibiotics to curb this problem. But over the years, it only became worse. And now, the rapid emergence of antibiotic-resistant bacteria has become a global threat in the field of medicine and to public health at large. 
&nbsp;

From being powerful enough to fighting bacterial infections, the existence of antibiotics is under threat again, mainly because of the overuse and misuse of the medication and a lack of new drug developments in the pharmaceutical industry.&nbsp;

&nbsp;

Understanding Microbial Resistance And Its Impact On Public Health

Antimicrobial is a term used to describe drugs meant for the treatment of bacterial, fungal, viral, protozoan, and parasitic infections. It includes antibiotics, antivirals, anti-fungals, and anti-parasitic drugs.&nbsp; 
&nbsp;

Antimicrobial resistance is described as the ability of microorganisms to grow in the presence of antimicrobial drugs i.e. these microorganisms thrive even in the presence of drugs that are designed to kill them!&nbsp;

&nbsp;

Antimicrobial resistance has emerged as one of the most concerning public health problems of the 21st century. It endangers the effectiveness of prevention and treatment programs for infections caused by microorganisms.&nbsp; 
&nbsp;

The misuse and overuse of antibiotics over the past couple of decades has caused common, or severe, infection-causing bacteria to develop resistance to antibiotics.&nbsp; 
&nbsp;

<h5>It&rsquo;s All In The Genes</h5>

Antimicrobial resistance generally occurs due to genetic changes. The organisms that are resistant to antimicrobials are found in food, plants, the environment, and people. The resistant microorganisms can spread between people, people and animals, and from food.&nbsp; 
&nbsp;

The main drivers of this resistance are:&nbsp;

<ul>
	<li>Misuse and overuse of antimicrobials&nbsp;</li>
	<li>Lack of proper hygiene and sanitation</li>
	<li>Lack of access to clean water&nbsp;</li>
	<li>Poor infection and disease control in healthcare facilities and farms</li>
	<li>Poor access to quality and affordable medications&nbsp;</li>
	<li>Lack of awareness, enforcement, and legislation&nbsp;</li>
	<li>Inappropriate handling of food can also encourage this resistance 
	&nbsp;</li>
</ul>

While antimicrobials including antibiotics, antivirals and anti-fungals save lives, their misuse contributes to the development of resistant germs i.e. these microorganisms change due to exposure to the antimicrobials, rendering the treatment ineffective.&nbsp; 
&nbsp;

Additionally, the antimicrobials kill helpful germs from our body that fight infection. So, antimicrobial-resistant germs survive and thrive freely. If that&rsquo;s not enough, these germs spread the resistant traits from their own DNA to other germs too.&nbsp; 
&nbsp;

The emergence and spread of drug-resistance microorganisms continue to threaten our ability to treat common infections. Multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR) bacteria, also known as superbugs, are spreading at an alarming rate, and causing infections that aren&rsquo;t treatable with already available antibiotics.

&nbsp;

Antibiotic resistance occurs when a small group of bacteria, that are treated with an antibiotic, survive. There are several reasons for it, including:&nbsp; 
&nbsp;

<ul>
	<li>The bacteria develop an ability to stop the effect of the medicine.&nbsp;</li>
	<li>The bacteria mutate, and the medicine no longer works.&nbsp;</li>
	<li>The bacteria develop the ability to remove the medicine from the cell.&nbsp; 
	&nbsp;</li>
</ul>

In essence, when bacteria become resistant to antibiotics, the antibiotics can no longer kill them, which further allows them to grow and spread. The resistance then spreads to other bacteria they meet, causing infections that are difficult to treat with antibiotics. 
&nbsp;

The use of antibiotics comes with the risk that some bacteria might become resistant. A major reason behind this is the misuse or overuse of antibiotics. Therefore, you should not be using antibiotics when they are not needed. 
&nbsp;

The overuse of antimicrobials causes these microorganisms to become resistant to treatment. In some cases, no drugs are effective, and all treatments fail. This leads to a significant increase in illness and mortality in humans. 
&nbsp;

The misuse and overuse of antimicrobials, especially antibiotics, are influenced by an interplay of different factors: 
&nbsp;

<ul>
	<li>A lack of regulation of the use of antimicrobial drugs.&nbsp;</li>
	<li>Over-the-counter availability of antimicrobials.&nbsp;</li>
	<li>Lack of awareness regarding excessive or inappropriate use of antibiotics.&nbsp;</li>
	<li>Over-prescription of antibiotics.</li>
	<li>Not finishing the entire course of antibiotics.&nbsp;</li>
	<li>Use of antibiotics in agriculture.&nbsp;</li>
	<li>Poor control of infection in<a href="https://merisehat.pk/article/accessing-quality-healthcare-online-doctors-in-pakistan"> healthcare</a> settings.&nbsp;</li>
	<li>Poor hygiene practices.&nbsp;</li>
	<li>Introduction of fewer new drugs.</li>
	<li>Poor compliance, i.e., not completing the course of antibiotics for the duration prescribed. 
	&nbsp;</li>
</ul>

The more people use antibiotics, the worse the gravity of the situation will become. A lot of times people use antibiotics when they are not actually needed. For example, even though antibiotics don&rsquo;t work against viruses, people would often use them for common viral infections such as the flu and common cold. As a result, antibiotics do not treat the viral infections, but they do put the individual at a higher risk of developing antibiotic resistance.&nbsp; 
&nbsp;

Another common reason that leads to antibiotic resistance is not completing the course of the medication needed to kill the bacteria. If you stop taking the antibiotics too early, the bacteria might become resistant, and you would not kill all the bacteria.&nbsp;

&nbsp;

Antibiotic-resistant infections spread in the same way as any other non-resistant bacterial infection. The bacteria can spread through coughs and sneezes, contaminated surfaces, sharing food with an infected person, a cut on the skin, or sexual contact.&nbsp;

Here are a few ways you can prevent the spread of bacterial infections:&nbsp; 
&nbsp;

<ul>
	<li>Regularly wash your hands with soap and water.&nbsp;</li>
	<li>Do not share your food and beverages with others.&nbsp;</li>
	<li>Practice safe sex.&nbsp;</li>
	<li>Cough or sneeze into a tissue and dispose of it properly. This will keep germs off your hands and prevent them from spreading to other people.&nbsp;</li>
	<li>Do not touch other people&rsquo;s wounds.&nbsp;</li>
	<li>Do not share personal items such as brushes, towels, or razors.&nbsp;</li>
	<li>Use regular soap for washing your hands. Soaps with antibacterial ingredients don&rsquo;t stop the spread of infections and may contribute to resistance.&nbsp;</li>
</ul>

&nbsp;

Conclusion

Important to remember is that using antibiotics only when needed is the best way to prevent antibiotic resistance.&nbsp; 
&nbsp;

Here are some ways you can prevent antibiotic resistance:

<ul>
	<li>Don&rsquo;t use antibiotics for a viral infection.&nbsp;</li>
	<li>Use antibiotics exactly as prescribed. Complete the full course of treatment and do not skip doses.&nbsp;</li>
	<li>Do not use an antibiotic without a doctor&rsquo;s prescription the next time you get sick.&nbsp;</li>
	<li>Do not self-medicate with an antibiotic that was prescribed for someone else.&nbsp; 
	&nbsp;</li>
</ul>

Other public health measures that can reduce the risk of antibiotic resistance include:&nbsp;

<ul>
	<li>Cutting the use of antibiotics in livestock.</li>
	<li>Use of methods that control the spread of infections in healthcare settings.&nbsp;</li>
	<li>Always maintaining good hygiene and sanitation.&nbsp;</li>
</ul>

&nbsp;

Key Points

<ul><li>Without effective tools to prevent drug-resistant infections and access to quality antimicrobials, the number of people dying because of infections would increase.&nbsp;</li><li>It would become riskier to perform medical procedures such as surgery, cancer chemotherapy, and organ transplantation.&nbsp;</li><li>The resistance continues to threaten our ability to treat common infections.&nbsp;</li><li>Antimicrobial resistance would prolong hospital stays, and increase the need for more expensive and intensive care. Thus, further burdening healthcare systems across the globe.</li></ul>

[1].Sengupta, S., Chattopadhyay, M.K. and Grossart, H.P., 2013. The multifaceted roles of antibiotics and antibiotic resistance in nature. Frontiers in microbiology, 4, p.47.

[2] Spellberg, B. and Gilbert, D.N., 2014. The future of antibiotics and resistance: a tribute to a career of leadership by John Bartlett. Clinical infectious diseases, 59(suppl_2), pp.S71-S75.