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Antimicrobial Resistance Awareness 2019- Dr. Babatunde Saka

Antimicrobial Resistance Awareness 2019

Dr. Babatunde Akeem Saka is a public health specialist with special interest in disease epidemiology and prevention. He works in multiple veterinary clinics, university veterinary teaching hospital, university slaughter slab as well as some agrochemical companies. In February 2018, Dr. Saka joined the GET Consortium as a researcher and in an administrative capacity as the Global Executive Secretary

 

The discovery of antibiotics remains the most significant health discovery to man. Penicillin which was discovered in 1928 signaled this era and over one hundred antibiotics have been used after penicillin (Davies, 2006).

Antibiotics are classified variously as first generation, second generation, third generation and even fourth generation based on the period of discovery. They are also classified as penicillins, cephalosporins, carbapenems, macrolides, fluoroquinolones, aminoglycosides, monobactams and others. Other classifications include their mechanisms of action.

However, the efficacy of antibiotics has now become a thing of concern. Microbials which the antibiotics are designed to fight and destroy have started developing evading mechanisms which is making antibiotics ineffective. This situation is described as antibiotic resistance or more commonly antimicrobial resistance (AMR).

This situation now complicates otherwise simple treatment processes and has led to a loss of lots of resources, time and life worldwide. Presently, about 70% of known infectious diseases originating from hospitals are resistant to at least one clinically relevant antimicrobial (Zhang et al., 2011).

Researchers now warn that the chances of a  return to the pre-antibiotic era is high. Recent results show that there are more than 20,000 potential resistance genes (r genes) of nearly 400 different types, predicted in the main from available bacterial genome sequences (Liu and Pop, 2009). This situation is coded for by antibiotic resistance genes (ARGs) which confers this capacity on the microbe through different means.

Before now, AMR development has been attributed largely to direct human consumption of antimicrobials.

Recent observation has however revealed that AMR has high contribution through disposal, use in food animal production and aquaculture. Each of these events brings antibiotics directly into the environment without passing through any physiological process which could have changed its form at all. The use of antibiotics in food animal production includes prophylaxis, treatment, control, growth-promoters for enhanced feed utilization and production.

Previous research has associated use of antibiotics in agricultural practices with antibiotic resistance development, resulting in calls for more judicious usage of antibiotics (Mathew et al., 2007; Silbergeld et al., 2008).

Many drug resistant strains of bacterials have been isolated from agricultural facilities and even the products (Rasheed et al., 2014; Ta et al., 2014). The same is reported for aquaculture (Saka et al., 2017; Shah et al., 2014).

A collaboration between the US Food and Drug Administration (FDA) Center for Veterinary Medicine, the US Department of Agriculture (USDA), and the Centers for Disease Control and Prevention (CDC) gave birth to the National Antimicrobial Resistance Monitoring System (NARMS) in 1996.

Unfortunately, most of the bacterial pathogens linked with epidemics of human disease have evolved into multidrug-resistant (MDR) forms due to antibiotic use. This situation has given rise to pathogens now referred to as Superbugs. Such pathogens have enhanced capacity to cause disease and death due to multiple mutations endowing high levels of resistance to the antibiotic classes specifically recommended for their treatment; the treatment options for these superbugs are reduced with extended hospital care and expense.

Often, such pathogens have also acquired increased virulence and enhanced transmissibility. Realistically, antibiotic resistance can be considered a virulence factor (Davies and Davies, 2010).

Highly prevalent pathogens, such as Escherichia coliSalmonella enterica, and Klebsiella pneumoniae, are responsible for a host of diseases in humans and animals, and a strong correlation between antibiotic use in the treatment of these diseases and antibiotic resistance development has been observed over the past half-century (Davies and Davies, 2010).

Presently, Staphylococcus aureus is the most notorious superbug in the lot. Clostridium difficile and Vibrio cholerae are other pathogens that have mutated into highly virulent superbugs with devastating capacity for morbidity and mortality.

The world celebrates AMR week. It is our responsibility to treat antimicrobials with extreme caution.

References

  1. Davies J. Where have all the antibiotics gone? Can J Infect Dis Med Microbiol. 2006;17(5):287.
  2. Zhang L, Kinkelaar D, Huang Y, Li Y, Li X, Wang HH. Acquired antibiotic resistance: are we born with it? Appl Environ Microbiol. 2011;77(89):7134–41. doi: 10.1128/AEM.05087-11
  3. Mathew AG, Cissell R, Liamthong S. Antibiotic resistance in bacteria associated with food animals: a United States perspective of livestock production. Foodborne Pathog Dis. 2007;4(89):115–33. doi: 10.1089/fpd.2006.0066.
  4. Silbergeld EK, Graham J, Price LB. Industrial food animal production, antimicrobial resistance, and human health. Annu Rev Public Health. 2008; 29:151–69. doi: 10.1146/annurev.publhealth.29.020907.090904.
  5. Rasheed MU, Thajuddin N, Ahamed P, Teklemariam Z, Jamil K. Antimicrobial drug resistance in strains of Escherichia coli isolated from food sources. Rev Inst Med Trop Sao Paulo. 2014;56(89):341–6. doi: 10.1590/S0036-46652014000400012.
  6. Ta YT, Nguyen TT, To PB, Pham DX, Le HTH, Thi GN, et al. Quantification, serovars, and antibiotic resistance of Salmonella isolated from retail raw chicken meat in Vietnam. J Food Prot. 2014;77(89):57–66. doi: 10.4315/0362-028X.JFP-13-221
  7. Shah SQA, Cabello FC, L’Abee-Lund TM, Tomova A, Godfrey HP, Buschmann AH, et al. Antimicrobial resistance and antimicrobial resistance genes in marine bacteria from salmon aquaculture and non-aquaculture sites. Environ Microbiol. 2014;16(5):1310–20. doi: 10.1111/1462-2920.12421.
  8. Liu, B., and M. Pop. ARDB—Antibiotic Resistance Genes Database. Nucleic Acids Res.37:D443-D447.
  9. Davies, J., & Davies, D. (2010). Origins and evolution of antibiotic resistance. Microbiology and molecular biology reviews : MMBR74(3), 417–433. doi:10.1128/MMBR.00016-10

 

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