Antimicrobial Resistance (AMR): Stopping the rise of superbugs!

Hello and welcome to this video where we’ll take a  quick look at antimicrobial resistance…one of the top global public health issues facing humanity So…. What is it? Why is it a problem?

What are the  main drivers? And… how do we to prevent it? Let’s start by taking a looking  at what antimicrobials are… Antimicrobials are agents that kill  microorganisms or inhibit their growth.

While they have been used in various forms such  as herbal treatments for thousands of years, the modern era of antimicrobials began  in the early 1900s with the creation of a compound called Salvarsan  and the discovery of penicillin. Since then, many different types of antimicrobials  were developed revolutionising medical practise. They are a key tool in our fight  against infectious diseases.

How do they work? Antimicrobials typically work by entering an organism, binding to specific  target sites, and blocking important processes in the organism that either kill  them, or stop them from multiplying. But….

. organisms have developed  several ways to resist antimicrobials. This is called Antimicrobial Resistance or AMR They are several mechanisms  by which they become resistant They include: Preventing access of the  antimicrobial into the organism Removing the antimicrobial  using pumps in the cell wall Destroying or inactivating  the antimicrobial with enzymes Changing the antimicrobial target  so that it cannot latch on to it…or Developing new processes that avoid  using the target of the antimicrobial These resistance traits can be passed on from one  generation to the next and also spread between organisms through various genetic elements.

Cross resistance can also occur, where an organism that is resistant to one antibiotic  can show some resistance to other types as well. AMR can occur in: Bacteria such as Staphylococcus  Aureus and mycobacterium tuberculosis Viruses such as influenza and HIV Parasites such as Plasmodium falciparum that causes malaria and Leishmania  species that cause leishmaniasis and…. Fungi such as candida auris and aspergillus.

Note that antibiotic resistance is a type  of antimicrobial resistance that is used to describe resistance to antibiotics  that are used to treat bacteria. Resistant organisms are  sometimes called “superbugs” Of particular concern are organisms  that are multi-resistant - showing resistance to more than one  antimicrobial - or those that are pan-resistant - showing resistance  to all known types of antimicrobials. The consequence of AMR is that  antimicrobials become ineffective, and therefore, infections are harder to treat.

Diseases that were once treatable may require treatment with alternative drugs which may be more  expensive, require treatment for longer periods of time, or not have any effective treatment at all. Procedures such as surgery, chemotherapy or transplantation can be very risky without  the protection offered by antimicrobials AMR can lead to adverse clinical  outcomes including death In addition to this, AMR can also  have a significant economic cost. At an individual level it can reduce  productivity and increased healthcare costs.

At a health systems level, there can be high costs associated with treating patients  with severe or prolonged illness. Let’s have a look at the drivers  behind the increase in AMR AMR a natural evolutionary  process that microorganisms use to avoid destruction and survive However, there are several drivers  that have accelerated this process. The main driver for AMR is the unrestrained  use of antimicrobials in humans and animals.

Antimicrobials are one of the most  commonly prescribed drugs for people, but unnecessary and inappropriate use is common. For example, using antibiotics for viral infections or not completing the  full course of the medication. Antimicrobials are widely used in animal husbandry  not only to treat disease but prophylactically to prevent infections and as a growth promoter.

Other drivers of AMR include poor water quality, sanitation and hygiene; inadequate infection  control practises and inappropriate food handling. These provide conditions in which resistant  organisms can emerge, multiply and spread. To add to this issue is the fact that there are  few new classes of antimicrobials being developed.

So how do we prevent AMR? AMR is a complex problem and preventing  it requires a multisectoral approach The World Health Organization’s Global action  plan provides a good framework to tackle AMR. It outlines 5 strategic objectives.

These are: Improving awareness and understanding  of antimicrobial resistance through effective communication education and training. Strengthening the knowledge and evidence  base through surveillance and research. This includes research to develop new  treatments, diagnostic tools and vaccines, clinical studies on effective antimicrobials  or alternatives to antimicrobials Reducing the incidence of infection  through effective sanitation, hygiene, and infection prevention measures.

This is particularly important in health care facilities. It also involves promoting hand hygiene, food, and water safety, developing new vaccines,  or promoting the use of existing vaccines. Optimizing the use of antimicrobial  agents in humans and animal health.

These include: At an industry level stopping the inappropriate  use of antimicrobials in agriculture Having antimicrobial stewardship programmes  - which are organizational or system-wide health-care strategies to promote the  appropriate use of antimicrobials through the implementation of evidence-based interventions And at a national level, having a strong legal and regulatory framework to ensure the rational  use of antimicrobials in animals and humans. Ensuring sustainable investment, and  increasing investment in new medicines, vaccines and diagnostic tools These actions require a whole of  society approach with everybody, in all sectors and disciplines working together. It includes taking a one health approach incorporating human health, animal health  and environmental factors into consideration.

And that’s an overview of AMR…. We have had a quick look at what it is, why it’s a problem, the main  drivers, and how we can prevent it.