ANTIMICROBIAL RESISTANCE

TAG: GS-3: SCIENCE AND TECHNOLOGY

CONTEXT: Recently, an international network under the Natural Livestock Farming Foundation, a non-profit, has developed an effective methodology to support farmers in reducing their use of antibiotics and other veterinary drugs in smallholder and large-scale dairy systems.

EXPLANATION:

What is Antimicrobial Resistance (AMR)?

Antimicrobial Resistance (AMR) is the resistance of microorganisms (bacteria, virus, parasites and fungi) to an antimicrobial agent (antibiotics, fungicides, antiviral agents and parasiticides), to which they were first sensitive.

• World Antimicrobial Awareness Week (WAAW) is a global campaign that takes place annually from November 18–24.
• The campaign’s goal is to raise awareness about antimicrobial resistance (AMR) and promote best practices to reduce the spread of drug-resistant infections.

Types of Antimicrobial Resistance:

1. Cross resistance: Resistance developed in microbes against antibiotics having similar structure.

2. Natural (intrinsic, structural) resistance: Natural resistance is caused by the structural characteristics of microbes. It is not associated with the use of antimicrobials. It has no hereditary property.

3. Acquired resistance: Acquired resistance develops due to the changes in the genetic characteristics of microbes, like changes in structures of chromosomes. This makes the microbes resistant to previous antimicrobial treatment.

4. Multi-drug resistance and pan-resistance: Resistance of microorganisms to a range of antimicrobials used to kill them. Multiple drugs and their enhanced generation are also not able to kill them.

The National Centre for Disease Control (NCDC) Report:

• Bacteria like E. coli, Klebsiella, Acinetobacter, Staphylococcus aureus, enterococcus have become resistant to even the latest generation of antibiotics.
• Third-generation antimicrobial drugs like cephalosporins, imidazoles, amino-glycosides, ceftriaxone, metronidazole, amikacin and piperacillin, used to treat cold, fever, skin diseases and urinary tract infection have become ineffective.
• Inappropriate use of antibiotics in human, animal and agricultural sectors has generated superbugs that are resistant to these antibiotic drugs, which spread due to inadequate sanitation and improper infection prevention in healthcare.

What are The Reasons Behind the Growth of Antimicrobial Resistance in India:

• Misuse of antimicrobial medicines:The use of antibiotic medicine in non-bacterial infections, use of over-the-counter antibiotics, self-medication and emergence of fixed drug compositions, have contributed to the increase in antimicrobial resistance in India.
• Overuse of antimicrobial medicines during the Covid-19 outbreak.
• Inadequate laboratory facilities-India lacks severely in the laboratory network and capacity to support Clinicians/Doctors with the bacterial culture test and suggesting an appropriate antibiotic.
• Lack of trained healthcare personnel: There is lack of adequate training of healthcare personnel in antibiotic selection, escalation, and de-escalation.
• Inadequacy of healthcare facilities: Overcrowded hospitals have left very little time for the doctors to examine patient’s medical history, conduct proper blood tests and then recommend proper antimicrobial treatment.
• Inappropriate use of antimicrobes in agriculture and allied sectors: The overuse of antimicrobials in agriculture and allied sector have led to increase in AMR.
• Inadequate monitoring-India lacks proper monitoring system to control the antibiotic prescription and dispensing practice by health system.
• Contamination around pharmaceutical manufacturing sites:The untreated waste from the pharmaceutical industries releases large amounts of active antimicrobials into the environment.
• Inadequate sanitation facilities-Poorly functioning sanitation systems like open defecation, poorly contained septic tanks have led to increase in AMR.
• No new antimicrobial developments:The exit of big pharma from antibiotic development and lack of investment from venture capitalists to support the commercial viability of antibacterial agents, has pushed AMR into a global health crisis.

Challenges posed by the spread of antimicrobial resistance:

• Threat to the health care system: The Antimicrobials helped in significantly reducing the mortality rates low and middle-income countries (LMICs) of Asia and Africa. The ineffectiveness would impair the modern health system by failing to prevent infections post a routine surgery or cancer treatment.
• Loss of Human Lives: AMR is responsible for up to 7 lakh deaths a year (GRAM project report). For ex- E. coli and MRSA (Methicillin Resistant Staphylococcus Aureus) are among the drug-resistant bacteria that lead to most deaths.
• Economic Brunt: As per an estimate by the Global Research on Antimicrobial resistance (GRAM) project, AMR can lead to an economic brunt on the world economy to the tune of US$ 1 trillion by 2050.

Initiatives:

• Delhi Declaration on AMR
• Red Line campaign
• National programme on AMR containment
• WHO’s Global Action Plan (GAP) on AMR, 2015

Source:

https://indianexpress.com/article/explained/explained-health/the-grave-threat-from-amr-9561108/