Question

Whar are the factors, processes, and mechanisms involved in antimicrobial resistance?

Answer 1

Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.

As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others. Antimicrobial resistance is driven by multiple factors. Resolving the threat to human and animal health presented by drug-resistant infections remains a societal challenge that demands close collaboration between scientists and citizens.

Factors involved in antimicrobial resistance:

1. Misuse of antibiotics in humans (e.g. not following the course of antibiotics, taking antibiotics for viral, rather than bacterial, infections)
2. Improper usage of antibiotics in animals (e.g. farming)
3. Waste products from antibiotics entering the environment (through manufacture, sewage and disposal)
4. Resistant bacteria being passed between people in hospital and other healthcare areas
5. A lack of quick, accurate tests to diagnose infections
6. A lack of effective vaccines and poor uptake of existing ones
7. Incorrect dosing of antibiotics in humans (e.g. not adjusting dosage for body weight)
8. Humans are one of the major sources of spreading resistant bugs as they travel from one place to another
9. Mass drug administration - i.e. the regular giving of antibiotics to a large group of people (e.g. a whole state or country) to treat an infection, regarless of whether individuals are ill or not

Purpose for antimicrobial resistance

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.

Antimicrobial resistance 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.

Mechanisms involved in antimicrobial resistance

The abilities of bacterial organisms to utilize the various strategies to resist antimicrobial compounds are all genetically encoded.

Intrinsic resistance is that type of resistance which is naturally coded and expressed by all (or almost all) strains of that particular bacterial species. An example of instrinsic resistance is the natural resistance of anaerobes to aminoglycosides and Gram-negative bacteria against vancomycin.

Changes in bacterial genome through mutation or horizontal gene acquisition,on the other hand, may consequently lead to a change in the nature of proteins expressed by the organism. Such change may lead to an alteration in the structural and functional features of the bacteria involved, which may result in changes leading to resistance against a particular antibiotic. This is referred to as acquired resistance, which is limited to selected isolates of that particular species or group of microorganisms.