Antibiotic resistance is one of the biggest threats to global health today. It occurs when bacteria change and become resistant to the antibiotics used to treat the infections they cause. Over-use and misuse of antibiotics in humans and animals is accelerating the process. Without urgent action, we are heading for a post-antibiotic era in which common infections could once again kill.
What is antibiotic resistance?
Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change to protect themselves from an antibiotic. When bacteria become resistant, antibiotics cannot fight them, and the bacteria multiply.
Some bacteria are naturally resistant to certain types of antibiotics. However, the overuse and misuse of antibiotics in humans and animals is accelerating the process of antibiotic resistance.
How do bacteria become resistant to antibiotics?
Bacteria can become resistant to antibiotics in several ways:
– Natural selection – Random genetic mutations lead to antibiotic-resistant strains of bacteria that are better equipped to survive exposure to antibiotics. These resistant bacteria then pass on the resistant genes when they reproduce.
– Genetic mutation – Bacteria can also gain antibiotic resistance through genetic mutation. Exposure to antibiotics can stress bacteria and cause them to mutate more frequently. Some of these mutations may result in antibiotic resistance.
– Gene transfer – Bacteria can share bits of genetic material called plasmids via horizontal gene transfer. These plasmids can contain antibiotic resistant genes, allowing resistance to spread between bacteria.
– Biofilm formation – Some bacteria produce biofilms – slimy layers of bacteria that act as shields against antibiotics. The bacteria inside biofilms can develop antibiotic resistance via genetic mutations and share resistance genes among themselves.
What factors contribute to antibiotic resistance?
The main factors driving antibiotic resistance include:
– Overuse of antibiotics – Taking antibiotics when not needed or not finishing a prescribed course of antibiotics allows the most resistant bacteria to survive and multiply. This promotes the development of antibiotic resistance.
– Inappropriate antibiotic prescribing – Doctors prescribing antibiotics for viral infections or when they are not needed puts selective pressure on bacteria to become resistant. About 30% of antibiotic prescriptions in the US are unnecessary.
– Overuse in livestock – The overuse of antibiotics in food animals to promote growth and prevent disease spreads resistant bacteria. More than 70% of antibiotics important for human medicine are sold for use in animals.
– Lack of new antibiotics – As bacteria become resistant to existing antibiotics, there is a lack of new antibiotics being developed to replace them. No new classes of antibiotics have been discovered since the 1980s.
– Poor infection control – Hospital-acquired infections and poor sanitation allows resistant bacteria to spread between patients. In the US, over 2 million people are infected with antibiotic-resistant bacteria each year.
– Lack of surveillance – There is a lack of coordinated global surveillance to track antibiotic resistance trends. This delays responses to rising and spreading resistance.
What types of infections are becoming resistant?
Many common bacterial infections in humans are becoming increasingly resistant to antibiotic treatment, including:
– Respiratory infections like pneumonia, tuberculosis, and influenza
– Skin infections like MRSA (methicillin-resistant Staphylococcus aureus)
– Sexually transmitted diseases like gonorrhea
– Urinary tract infections caused by E. coli, Klebsiella pneumoniae, and others
– Bloodstream infections (sepsis) caused by E. coli, S. aureus, and Enterococci
– Foodborne infections like salmonella and campylobacter
– Hospital acquired infections like those caused by Enterococcus faecium and Acinetobacter
According to the CDC, each year in the US at least 2.8 million people are infected with antibiotic-resistant bacteria or fungi, and more than 35,000 people die as a result. Globally, it is estimated about 700,000 people die from antibiotic-resistant infections each year.
What are the consequences if antibiotic resistance continues?
Some of the potential health and economic impacts if antibiotic resistance continues unchecked include:
– More frequent and severe bacterial infections – Common infections and minor injuries could once again kill as antibiotic treatments become ineffective.
– Rise in ‘superbugs’ – Multi-drug resistant bacteria would spread, causing deadly pandemics. Superbugs like MRSA already kill thousands each year in the US.
– Difficulty controlling infectious diseases – Many surgeries, cancer treatments, and organ transplants that rely on antibiotics would become very high risk without effective antibiotics.
– Higher healthcare costs – Lengthier hospital stays and requirements for isolation and control procedures would increase healthcare expenses.
– Animal health issues – Infections would spread more easily among livestock, driving up meat prices and threatening food security.
– Economic damage – The world economy could be negatively impacted by costs of managing drug resistant infections estimated at $100 trillion USD by 2050 if no action is taken.
| Year | Estimated Deaths from Antibiotic Resistance |
|---|---|
| 2014 | 700,000 |
| 2050 (estimated) | 10 million |
How can antibiotic resistance be slowed?
Some strategies and policies that could help slow the spread of antibiotic resistance include:
– Improving antibiotic prescribing – Reduce overuse by prescribing narrow-spectrum targeted antibiotics only when needed based on diagnostic testing.
– Limiting antibiotic use in livestock – Restrict non-therapeutic uses of antibiotics in animals like for growth promotion. This can be done by setting maximum limits for antibiotic use.
– Improving infection control – Implement procedures like hand washing, sterilization of hospital surfaces, and isolation of infected patients to prevent spread of resistant bacteria, especially in healthcare settings.
– Developing new antibiotics – Provide incentives to pharmaceutical companies to develop new classes of antibiotics to replace those rendered ineffective by resistance.
– Tracking and surveillance – Establish robust global surveillance networks to monitor antibiotic resistance patterns and trends. This improves early warning and response capabilities.
– Educating communities – Run public awareness campaigns to educate people about proper antibiotic use and the dangers of antibiotic resistance. This helps change behavior and attitudes around antibiotic use.
– Investing in research – Increase funding for academic research focused on better understanding mechanisms of antibiotic resistance and discovering new treatment options to target resistant bacteria.
What will happen by 2050 if no action is taken?
The impacts of antibiotic resistance continue to grow and by 2050, the consequences could be catastrophic without concerted global action today. Some projections indicate:
– Common infections could once again kill – Respiratory infections, STDs, sepsis – could all become untreatable with currently available antibiotics.
– Routine medical procedures will carry risk – Minor surgeries, caesarean sections, joint replacements will become very high risk without effective antibiotics to prevent infections.
– Economic damage could be severe – The cumulative global cost of antibiotic resistance could exceed $100 trillion by 2050, causing significant economic recession.
– Millions could die each year – Estimates indicate antibiotic resistance could cause up to 10 million deaths per year by 2050 if no action is taken.
– Medical care disruption – Many modern medical and surgical advances that rely on the availability of effective antibiotics may revert back to basic care.
– Spiraling health care costs – Lengthy hospital stays and isolation procedures will become necessary as infections become more widespread and untreatable.
– Superbugs could spread – Highly resistant and deadly bacteria like carbapenem-resistant Enterobacteriaceae (CRE) could become widespread, causing large outbreaks.
Conclusion
Antibiotic resistance is a critical threat to public health globally. Over-use of antibiotics in humans and animals is accelerating the emergence of resistant superbugs. Without concerted efforts to change behavior, improve prescribing practices, implement infection control measures, develop new antibiotics, and track resistance, we face the real possibility of entering a post-antibiotic era in which minor infections could once again prove deadly. Global cooperation and immediate action across sectors is required to avert the potentially devastating impacts antibiotic resistance could have on health, economies, and modern medicine as we know it.