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Recent Edition
Editorial
Volume 1 Issue 5 - 2017
Antimicrobial Resistance: A Major Issue in Global Public Health
Ram Hari Dahal*
Department of Microbiology, Tri-Chandra Multiple Campus, Tribhuvan University, Katmhandu, Nepal
*Corresponding Author: Ram Hari Dahal, Department of Microbiology, Tri-Chandra Multiple Campus, Tribhuvan University, Katmhandu, Nepal.
Received: November 06; Published: November 14, 2017
Keywords: Antimicrobial resistance; global issue; microbial infection; MRSA; financial burden
Introduction
Antibiotics are the drugs that either kill or inhibit the growth of microorganisms. In recent years, the continuous use of antibiotics is increasing due to which the antibiotics are losing its effectiveness and as a consequence antimicrobial resistance is increasing. Antimicrobial resistance (AMR) is not only a major life-threatening challenge to public health in the world but also aids financial burden to the public [1].
Almost all well-known antimicrobial agents lost their efficacy in previous form and become resistant to most common disease causing microbes which ultimately leads to multi-drug resistant (MDR). In recent days, most commonly used antibiotics like amoxicillin, cephalexin, erythromycin, ciprofloxacin, co-trimoxazole, tetracycline, and gentamicin have been continuously elevating their abilities to inhibit the pathogenic organisms.
Multi-drug resistant organism such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci,extended-spectrum β-lactamase (ESBL)-producing organisms, MDR Pseudomonas aeruginosa, MDR Acinetobacter, carbapenemase-producing Enterobacteriaceae (CPE) and multi-drug resistant forms of tuberculosis (MDR-TB) are principal issues and account for a major hospital-acquired infections [2–6]. Gram-positive bacteria, Staphylococcus aureus and Enterococcus spp. pose the greatest threat to public health [7].
Rise of antimicrobial resistance and its consequences
First antibiotic resistance was reported in 1940 with penicillin-resistant Staphylococcus [1]. The mechanism of antimicrobial resistance is a natural phenomena and develops when bacteria degrades antimicrobial drugs and alter bacterial proteins that are antimicrobial targets or changes in membrane permeability to antibiotics [8]. Basically improper treatment of antibiotics is a major cause for increment of resistant microbes.
In addition, various factors have contributed for the elevation of antimicrobial resistance which includes: over-the-counter access, misuse, pressure to prescribe antimicrobials unnecessarily, and failure to complete full course of treatment of antibiotics [1,9]. Use of antibiotics without doctor’s prescription and medicating antibiotics for treatment of very simple illness such as common cold is a good example to contribute the rise in antimicrobial resistance.
Antimicrobial resistance is a global complication in public health. Centers for Disease Control and Prevention (CDC) estimates that antimicrobial resistance is responsible for more than two million infections and 23,000 deaths each year in the United States only [10]. Consumption of antimicrobial drug is increasing continuously and demands continue to rise. In 2000-2010, total global antibiotic consumption was raised by 30% [11].
The disease caused by antimicrobial-resistant microbes usually fails to standard drug therapy which leads to financial burden to patients due to longer periods of hospitalization. Increasing antimicrobial resistance prolongs the illness and results failure with first-line antimicrobial drug treatment which may urge to treat with second-line or third-line drugs [1].
Strategy for the reduction of antimicrobial resistance
Lack of appropriate policy of a country and poor awareness for use of antimicrobial agents has led to brutal scenario of antimicrobial resistance. This nightmare of antimicrobial resistance should be addressed in all countries. Discovery of novel antibiotics may be a choice to solve this problem but only a few antibiotics have been discovered in recent decades [12].
In the contrary, proper diagnosis and appropriate treatment of microbial diseases should be done to maintain the effectiveness of antibiotics. WHO (World Health Organization) issued a six-point policy package to counter the spread of antimicrobial resistance on World Health Day, 2011 [13]. In addition, control of spreading resistant bacteria may help to maintain the effectiveness of antibiotics.
References
  1. Ventola CL. “The antibiotic resistance crisis: part 1: causes and threats.” 40.4 (2015):277–283.
  2. Gillespie SH. “Evolution of drug resistance in Mycobacterium tuberculosis: clinical and molecular perspective”. Antimicrobial Agents and Chemotherapy 46.2 (2002): 267–274.
  3. Otto M. “Staphylococcus epidermidis- the “accidental” pathogen”. Nature Reviews Microbiology 7 (2009): 555–567.
  4. Boucher HW., et al. “Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America.” Clinical Infectious Diseases 48.1 (2009):1-12.
  5. Stalin MJ and Walsh TJ. “Multidrug-resistant Enterobacteriaceae, Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus: Three major threats to hematopoietic stem cell transplant recipients.” Transplant Infectious Disease (2017): 
  6. Taneja N and Kaur H. “Insights into newer antimicrobial agents against Gram-negative bacteria.” Microbial Insights 9 (2016): 9–19.
  7. Rossolini GM., et al. “Update on the antibiotic resistance crisis.” Current Opinion in Pharmacology 18 (2014): 56–60.
  8. Dever LA and Dermody TS. “Mechanisms of Bacterial Resistance to Antibiotics.” Archives of Internal Medicine 151.5 (1991): 886–895.
  9. Hamilton-Miller JM. “Use and abuse of antibiotics.” British Journal of Clinical Pharmacology 18.4 (1984): 469–474.
  10. Centers for Disease Control and Prevention (CDC). “Antibiotic resistance and threats in the United States 2013”.
  11. Van Boeckel TP., et al. “Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data.” The Lancet Infectious Diseases 3099.14 (2014): 1–9.
  12. Ventola CL. “The antibiotic resistance crisis: part 2: management strategies and new agents.” P T 40.5 (2015): 344–352.
  13. The WHO policy package to combat antimicrobial resistance. Bull World Health Organ 89.5 (2011): 390-392.
Citation: Ram Hari Dahal. “Antimicrobial Resistance: A Major Issue in Global Public Health”. Clinical Biotechnology and Microbiology 1.5 (2017): 186-188.
Copyright: © 2017 Ram Hari Dahal. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.