What it is, why it’s a global concern and how to protect yourself from it

Antimicrobial resistance, also known as AMR, occurs when bacteria, fungi, viruses, and parasites change over time and fail to respond to drugs.

World Antimicrobial Awareness Week or WAAW is observed annually between 18 aNovember 24. The theme for 2021 is ‘Building Awareness, Stopping Resistance’. The awareness movement, in line with this year’s theme, calls on health actors, healthcare providers, policy makers and especially the general public to be champions in raising awareness about antimicrobial resistance (AMR).

What are antimicrobials?

Before we dive into antimicrobial resistance, let’s first look at what antimicrobials are. Antimicrobials refer to drugs used to prevent and treat infections in humans, animals and plants. Infections are caused by bacteria, viruses, fungi and parasites. Antimicrobials are therefore umbrella terms that include antibacterials, antivirals, antifungals, and antiparasitics.

“Antibacterial” includes drugs derived from bacteria or molds or that are synthesized. Antibiotics refer only to antimicrobials produced from bacteria or molds but now the term antibiotic is also used when it means “antibacterial drug”.

What is Antimicrobial Resistance?

Now that the term “antimicrobial” is clear, let’s look at what antimicrobial resistance means. Antimicrobial resistance, also known as AMR, occurs when bacteria, fungi, viruses, and parasites change over time and fail to respond to drugs. This makes infections more difficult to treat and ultimately leads to the infection spreading, leading to severe illness and sometimes even death.

Why is antimicrobial resistance a global concern?

AMR is one of the top ten global public health threats facing humanity. The emergence and spread of antimicrobial resistant organisms has a direct impact on the ability to treat common infections. We are all aware of the global spread of superbugs which are multi and pan resistant bacteria. These cause infections that cannot be treated by existing antibiotics.

Although we need new antibiotics, changing the way antibiotics are used is important. If our behavior towards antibiotics does not change, new antibiotics will also eventually become ineffective.

Antibiotic resistance leads to increased medical costs, longer hospital stays and an increased death rate. The cost of antimicrobial resistance to health systems and national economies is therefore considerable.

What accelerates the emergence and spread of antimicrobial resistance?

Antimicrobial resistance occurs naturally over a period of time and often through genetic changes. Antimicrobial resistant organisms are found in environments that are found in water, soil and air. They are also found in animals, plants, foods and humans. These organisms can spread from person to person and even between people and animals, including from food of animal origin.

What drives and drives antimicrobial resistance?

  • Misuse of antimicrobials
  • Excessive use of antimicrobials
  • Lack of access to drinking water
  • Sanitation and hygiene factors for both humans and animals
  • Poor infection control and disease prevention measures in health facilities and on farms.
  • Lack of access to quality and affordable medicines, vaccines and diagnostics
  • limited access to quality and affordable medicines, vaccines and diagnostics
  • Lack of AMR awareness
  • Inadequate regulation and lack of enforcement of regulations

How do we manage RAM?

AMR requires a united and multi-sector approach due to its complexity. The One Health approach aims to bring together multiple sectors and stakeholders involved in the health of humans, terrestrial and aquatic animals and plants, as well as in the production of food and feed. The approach aims to work together in implementing programs, policies, research and legislation to achieve better public health outcomes.

Isn’t it more practical to develop newer and more potent antimicrobials?

The development of new antimicrobials is a long and arduous process with multiple challenges and it goes without saying that it is expensive. It also takes a long time for it to be delivered to the market from the time it is developed. The number of new antimicrobials launched has decreased over time. It is important that antimicrobials are used appropriately to overcome the dangers of AMR, regardless of the supply of new antimicrobials.

What should we do to protect ourselves and our family against AMR?

It’s not possible for anyone to completely avoid an infection, but we can all take a few steps to minimize the risk.

  • Stay healthy and keep others healthy

Wash your hands with soap and water, cover your mouth and nose when you cough or sneeze. It’s important to stay home when you’re sick so you don’t put others at risk. The use of masks is recommended, especially if it is an infection of the upper respiratory tract. Avoid close contact with people who are sick, have a cold, or have an upper respiratory infection. Avoid touching eyes, nose and mouth with unwashed hands.

  • Be Antibiotic SMART with proper use of antibiotics

First, antibiotics should only be taken when prescribed by a certified medical professional. Never use antibiotics on your own. It is important to take antibiotics exactly as prescribed by the doctor and for the full duration suggested by the doctor. Throw away any remaining antibiotics and never use them for any future illness. Please do not share antibiotics with other people, even in the family, and do not take antibiotics that have been prescribed for someone else.

  • Maintain healthy habits around animals

It is important to wash your hands thoroughly after touching, feeding or caring for animals. It is also important to keep the animals healthy to avoid the risk of infection.

Follow the WHO Five Keys to Safe Food:

  • Clean your hands, kitchen utensils and surfaces
  • Separate raw foods from cooked foods
  • Cook well
  • Refrigerate leftovers immediately
  • Use safe and clean water and raw materials

It is also important to choose foods that have been produced without the use of antibiotics to promote growth or prevent disease in healthy animals.

  • Stay healthy when traveling

Be vigilant and aware when traveling abroad. Know what vaccinations are needed for where you are going and make sure you are consuming safe food and drink.

Key messages for Antimicrobial Awareness Week

  • It is clear that antimicrobials are a valuable resource whose usefulness is lost without proper use,
  • Antimicrobial resistance is happening NOW and is a global problem affecting both human and animal health
  • Antibiotic resistance occurs when bacteria prevent an antibiotic from working effectively, which means some infections can become untreatable
  • Due to limitations in the development of new antimicrobials, few new antimicrobials are being developed to address the challenge of antimicrobial resistance
  • Misuse of antimicrobials contributes to antimicrobial resistance.
  • Antimicrobials, when used, should be used appropriately and with great care.

Dr. Ekta Patil is the Senior Microbiologist at SRL, Global Reference Laboratory in Mumbai. She joined SRL in 2014 as a microbiologist and now leads the microbiology and serology section of the SRL Mumbai lab. She is an SME (Subject Matter Expert) for microbiology and serology and also a member of COTE (Council of Quality & Technical Excellence) at SRL. She did her MBBS and MD from TNMC and Nair Hospital. She is an NABL certified internal auditor. His areas of interest relate to antimicrobial resistance and mycobacteriology. With various publications to her credit, she has also given talks at scientific meetings and conferences.

Teresa H. Sadler