Antimicrobial Resistance & Global Impact.

HEALTH
28 Dec, 2022

NEWS HIGHLIGHT 

Theme : Health
Paper:GS-2 and GS-3

 

1.27 million people died in 2019 as a direct result of AMR, which is now a leading cause of death worldwide, higher than HIV/AIDS or Malaria according to a study published in Lancet.

 

TABLE OF CONTENT

  1. Context
  2. Antimicrobial Resistance
  3. Situation in India
  4. Causes Behind Acquired Antimicrobial Resistance
  5. Global Research on Antimicrobial Resistance (GRAM) report
  6. During the COVID How did Antibiotics Impact

Context :  1.27 million people died in 2019 as a direct result of AMR, which is now a leading cause of death worldwide, higher than HIV/AIDS or Malaria according to a study published in Lancet.

 

Antimicrobial Resistance : 

  • The term antibiotic resistance is a subset of antimicrobial resistance or AMR which is the ability of a microbe to resist the effects of medication.
  • Antimicrobial resistant-microbes occur naturally and are found in people, animals, food, and the environment (in water, soil and air).
  • They can spread between people and animals, including from food of animal origin, and from person to person.
  • Inadequately treated sewage waste containing resistant bacteria which mixes in the environment also magnify the burden of AMR.
  • Poor infection control, inadequate sanitary conditions and inappropriate food handling encourage the spread of AMR.
  • AMR is facilitated by the inappropriate use of medicines, for example, using antibiotics for viral infections such as the flu.

Situation in India : 

  • India is among the nations with the highest burden of bacterial infections.
  • An estimated 4,10,000 children aged five or less die from pneumonia in India annually; with pneumonia accounting for almost 25 % of all child deaths.
  • The crude mortality from infectious diseases in India today is 417 per 1,00,000 persons.
  • The Food Safety and Standards Authority of India (FSSAI) banned the use of antibiotics and several pharmacologically active substances in fisheries.
  • There is no regulation in the poultry industry where many of the commercially available pre-mixed feeds come with added antibiotics.

Causes Behind Acquired Antimicrobial Resistance : 

  • Overuse, misuse, and improper use (e.g., taking antibiotics to treat viral diseases!) of antimicrobials.
  • Greater access to over-the-counter antibiotic drugs in developing countries.
  • Using broad-spectrum antibiotics over narrow-spectrum antibiotics (targeting specific microbes only).
  • Dumping of inadequately treated effluents from the pharmaceutical industry.
  • Antibiotic use in livestock feed at low doses for growth promotion is industrialized countries.
  • Poor sanitation and hygiene that forces the extended use of antimicrobials.

Global Research on Antimicrobial Resistance (GRAM) report : 

  • The Global Research on Antimicrobial Resistance (GRAM) report used statistical modeling to estimate deaths linked to 23 pathogens and 88 pathogen-drug combinations.
  • Apart from 7 lakh deaths caused directly by AMR (these would not have occurred had the infections been drug-susceptible), another 49.5 lakh deaths were associated with AMR (a drug-resistant infection was implicated, but resistance itself may or may not have been the direct cause of death).
  • HIV/AIDS and malaria were estimated to have caused 8.6 lakh and 6.4 lakh deaths respectively in 2019.
  • Of the 23 pathogens studied, drug resistance in six (E coli, S aureus, K pneumoniae, S pneumoniae, A baumannii, and P aeruginosa) led directly to 9.29 lakh deaths and was associated with 3.57 million.
  • One pathogen-drug combination – methicillin-resistant S aureus, or MRSA – directly caused more than 1 lakh deaths.
  • Resistance to two classes of antibiotics often considered the first line of defense against severe infections – fluoroquinolones and beta-lactam antibiotics – accounted for more than 70% of deaths caused by AMR.

During the COVID How did Antibiotics Impact : 

  1. Until changes in ICMR guidelines earlier this week, azithromycin was routinely prescribed for all Covid patients even though there is no evidence that this is helpful.
  2. The absolute lack of regard for the life-saving value of antibiotics may come back to haunt us when we need these drugs for bacterial infections.

FAQs : 

  1. What is AMR ?

ANS. 

  • The term antibiotic resistance is a subset of antimicrobial resistance or AMR which is the ability of a microbe to resist the effects of medication.
  • Antimicrobial resistant-microbes occur naturally and are found in people, animals, food, and the environment (in water, soil and air).
  • They can spread between people and animals, including from food of animal origin, and from person to person.
  1. List a few causes of Acquired AMR ?

ANS. 

  • Overuse, misuse, and improper use (e.g., taking antibiotics to treat viral diseases!) of antimicrobials.
  • Greater access to over-the-counter antibiotic drugs in developing countries.
  • Using broad-spectrum antibiotics over narrow-spectrum antibiotics (targeting specific microbes only).
  • Dumping of inadequately treated effluents from the pharmaceutical industry.