Infections:What causes anti-microbial resistance?
Sunday, November 15, 2020
The main cause of antibiotic resistance is antibiotic use. / Photo: Net

According to the Center for Disease Control and Prevention-CDC, antibiotic resistance happens when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them. The germs are not killed and continue to grow.

CDC states that the infections caused by antibiotic-resistant germs are difficult, and sometimes impossible to treat. In most cases, antibiotic-resistant infections require extended hospital stays, additional follow-up doctor visits, and costly and toxic alternatives.

Antibiotic resistance does not mean that the body is becoming resistant to antibiotics; it is that bacteria have become resistant to the antibiotics designed to kill them.

The World Health Organization-WHO states that antimicrobial or antibiotic resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.

AMR occurs when bacteria, viruses, fungi, and parasites, change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others, WHO notes.

WHO adds that the antimicrobials - including antibiotics, antivirals, antifungals and anti-parasitics - are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as "superbugs”.

Antimicrobial resistance is not a commonly crossed topic in Rwanda, in spite of being a crucial topic which concerns keeping antibiotics working whenever needed.

It is for this reason that OAZIS Health Rwanda in collaboration with University of Manchester, organised the 30 Days of Antibiotic Stewardship campaign that was to mobilise the public to make better use of antibiotics.

The campaign included activities to prevent infection, the appropriate use of antibiotics, and seeking help for cautious use. This was done by using an open-access, free, online course where the public was called to join.

The antibiotic movement also aimed at encouraging people to wash their hands, never use antibiotics for colds, or do self-prescribe antibiotics.

OAZIS Health has also introduced a certified online course to increase the general understanding of antibiotic resistance and how it affects everyone.

Antibiotic resistance is not new, in fact, it has increased so much that people around the world are developing bacterial infections that can’t respond to existing antibiotics.

Dr Sylvain Habarurema, a consultant in internal medicine at University Teaching Hospital of Butare (CHUB), explains that antimicrobial resistance occurs when microbes change overtime to overcome the action of antimicrobials so that they are no longer effective. At that time, the microbes responsible for infections become harder to treat which leads to severe illness.

He says that microbes are an entity made of fungi, bacteria, viruses and parasites and some of the common bacteria resistant to antibiotics are; methicillin-resistant staphylococcus aureus (MRSA), vancomycin resistant enterococcus (VRE), multidrug resistant mycobacterium tuberculosis (MDR-TB) and carbapenem resistant enterobacteriaceae (CRE).

He adds that all bacteria can become resistant to an antimicrobial.

WHO highlights prevention and control of the spread of antibiotic resistance to individuals through only use of antibiotics when prescribed by a certified health professional. Do not ask for antibiotics if your health worker says you don’t need them, always follow your health worker’s advice when using antibiotics, and never share or use leftover antibiotics.

Avoid infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practicing safer sex, and keeping vaccinations up to date.

But also, to prepare food hygienically, following WHO’s five keys to safer food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials), and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals.

UN, international agencies and experts in 2019 released a radical report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.

If no action is taken - warns the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008 to 2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.

In 2019, WHO reported that at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multidrug-resistant tuberculosis. More and more common diseases, like respiratory tract infections, sexually transmitted infections, and urinary tract infections, are untreatable; lifesaving medical procedures are becoming much riskier, and our food systems are increasingly precarious.