Antimicrobial resistance is one of the greatest threats facing humanity. But what is it and how do we slow the rise?
While Australia is still in recovery mode from the COVID-19 pandemic, there is another global emergency ready to erupt: antimicrobial resistance (AMR).
Each year 1.27 million people die from infections caused by antibiotic resistant pathogens. While an estimated five million people die with an AMR infection. This is greater than the number of deaths from HIV/AIDS and malaria combined.
Given the likelihood of spread and the already concerning prevalence, the World Health Organization (WHO) has declared AMR to be one of the top 10 public health threats facing humanity.
What is antimicrobial resistance (AMR)
Anti-microbials are products such as antibiotics that kill or slow the spread of microorganisms including bacteria. We use them to prevent and treat infections in humans, animals and plants.
AMR occurs when antimicrobial treatments are no longer effective against the microorganisms they were designed to kill. You may have heard of the term “superbugs”. These are bacteria resistant to multiple antimicrobials (and sometimes all of them).
Humans are not resistant to antimicrobials — only the bugs living inside us are. However, we can pass the bugs to each other and other species of animals.
How did this happen?
Causes of AMR involve several factors. Over time, bacteria can adapt and get stronger against antimicrobials. Overuse and misuse of antimicrobials in humans and via farming and veterinary practices in animals allows this adaptation process to occur with speed and effectiveness.
On top of this, bacteria are experts at replicating their genes. Genes in bacteria can be passed to other disease-causing as well as non-harmful bacteria. This is called horizontal gene transfer, and results in antimicrobial genes being transferred across species.
Once resistant microorganisms develop, they can enter the food chain via waterways, soil and air, as well as food handling and packaging.
Although not a disease itself, AMR is a feature of infectious disease. Many disease-causing bacteria have different disease outcomes. This makes measuring prevalence and impact – or “burden” – difficult to track.
For human AMR infections, currently we have two established methodologies to determine the burden of disease. These include quantifying the burden due to hospital-associated infection and the burden due to community-acquired infections.
While we understand the burden of certain hospital acquired infections, we know less about the impact of AMR in the community. A recent study suggests drug-resistant infections acquired in the community are a major concern and could increase the risk of death, even for common infections such as urinary tract infections.
Some simple ways you can help reduce AMR
You can play a part in slowing the rise of antimicrobial resistance by doing these small things.
1. Wash your hands
Bacteria live on skin and on objects. Good hand hygiene is an inexpensive and simple way to prevent all types of bacteria, including AMR bacteria, from spreading.
2. Keep your environment clean
This doesn’t just apply to hospitals. Keeping the home clean – and even taking your shoes off before you walk inside – can help reduce the spread of harmful bacteria from the environment.
3. Use good food preparation hygiene
Wash your fruits and vegetables thoroughly. Transportation, packaging and presentation often expose food to bacteria. You can reduce the risk of ingesting resistant bacteria someone may have left on your apple when they touched it in the store by washing it before eating.
4. Don’t misuse antibiotics and properly dispose of unused antibiotics
Take antibiotics only when appropriate and necessary. Follow the instructions on the packet. Don’t use other people’s antibiotics. If you have any antibiotics left over, do not put them in the bin or the drain. Instead, dispose of them at your local pharmacy.