Sunday, March 17, 2024

Bacteria That Is Antibiotic Resistant

How Can I Improve Antibiotic Use

What causes antibiotic resistance? – Kevin Wu

No one can completely avoid getting an infection, but there are additional steps you can take to protect yourself and your family.

Taking antibiotics only when they are needed is an important way you can protect yourself and your family from antimicrobial resistance. Talk to your doctor about the best treatment if you are sick. Never pressure your doctor to prescribe an antibiotic.

When antibiotics arent needed, they wont help you, and their side effects could still cause harm. Ask your doctor or pharmacist about steps you can take to feel better when an antibiotic isnt needed.

If your doctor decides an antibiotic is the best treatment when you are sick:

  • Take the medication exactly as your doctor tells you.
  • Do not share your medication with others.
  • Do not save them for later. Talk to your pharmacist about safely discarding leftover medicines.
  • Do not take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.
  • Talk with your doctor and pharmacist if you have any questions about your antibiotics prescribed to you.

Drug Resistance In Malaria Parasites

The emergence of drug-resistant parasites poses one of the greatest threats to malaria control and results in increased malaria morbidity and mortality. Artemisinin-based combination therapies are the recommended first-line treatment for uncomplicated P. falciparum malaria and are used by most malaria endemic countries. ACTs are a combination of an artemisinin component and a partner drug. In the WHO Western Pacific Region and in the WHO South-East Asia Region, partial resistance to artemisinin and resistance to a number of the ACT partner drugs has been confirmed in Cambodia, Lao Peoples Democratic Republic, Myanmar, Thailand, and Viet Nam through studies conducted between 2001 and 2019. This makes selecting the right treatment more challenging and requires close monitoring.

In the WHO Eastern Mediterranean Region, P. falciparum resistance to sulfadoxine-pyrimethamine led to artesunate-sulfadoxine-pyrimethamine failures in some countries, necessitating a change to another ACT.

In Africa, evidence has recently been published showing emergence of mutations linked to partial artemisinin resistance in Rwanda. So far, ACTs that have been tested remain highly efficacious. However, further spread of resistance to artemisinin and ACT partner drugs could pose a major public health challenge and jeopardize important gains in malaria control.

Prevention And Drug Development

The prospects of scientists developing new antibiotics as fast as bacteria develop resistance are poor. Therefore, other measures have been undertaken, including educating the public about the proper use of antibiotics and the importance of completing a full regimen as prescribed. Improvements in diagnostic equipment to facilitate the isolation and detection of resistant bacteria such as MRSA in hospital settings have enabled rapid identification of these organisms within hours rather than days or weeks. In addition, although efforts to fight bacteria by targeting them with bacteriophages were largely abandoned with the discovery of penicillin and broad-spectrum antibiotics in the 1940s, the growing presence of resistance has renewed interest in these methods. In addition, a significant amount of phage-therapy research was conducted throughout the 20th century in regions within the former Soviet Union. As a result, today in Georgia, which was once under Soviet rule, bandages saturated with bacteriophages against staphylococcus are commercially available as topical treatments for wounds and burns. In the 21st century, researchers worldwide were working to develop other topical and systemic phage therapies.

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Infection Control And Antibiotic Use

Recommendations by the Society for Healthcare Epidemiology of America have been drafted to help control antibiotic resistance in LTCFs. These recommendations include antibiotic restriction practices, nontreatment of asymptomatic bacteriuria, minimal use of topical antibiotics, hand washing, and barrier precautions for wound care . I propose that at LTCFs, the following additional actions be specifically stressed: regular education of nursing and physician personnel and surveillance at the time of admission for antibiotic resistance.

Continuing medical education concerning the imprudent use of antibiotics needs to be the first step. Alerting staff to the dangers of excess antibiotic use and the epidemiology of current outbreaks will help with enforcing infection-control guidelines in the community. Education of the physician and nursing staffs is also needed to determine whether infection is present. Use of the definitions of infection in residents of LTCFs developed by McGeer et al. , which can serve as a guide, is encouraged. Nursing personnel instructed in the use of these guidelines can assist physicians with treatment decisions. Infection-control surveillance also helps to identify the presence and spread of resistance.

Eliminate Meat Raised With Antibiotics

Antibiotics: What You Need to Know  Morning Sign Out

Antibiotic-resistant bacteria can spread not only person-to-person but also through animals and the food supply. Experts say regular use of antibiotics in farm animals is a contributor to antibiotic resistance.

In fact, in 2017, the World Health Organization recommended that the food industry stop routinely using antibiotics in healthy animals as a way to promote growth and prevent disease.

For example, when farmers use antibiotics to treat livestock, antibiotic-resistant bacteria can survive in the animals’ bodies and remain present when sold in grocery stores. As well, these bacteria can contaminate other products through contact with livestock waste and wastewater.

Because of this, experts underscore the importance of trying to buy meat that is antibiotic-free whenever possible. Check the package label for wording such as “raised without antibiotics,â “no antibiotics administered,” and in some cases “organic.”

You might also work toward minimizing the amount of meat in your diet or eliminating it altogether.

Antibiotic-resistant bacteria can make their way to humans through animals and the food supply in a few ways. These bacterial infections can be contracted by:

  • Handling food that is raw, undercooked, or contaminated with antibiotic-resistant bacteria
  • Coming into contact with animal waste, either directly or through the water system or environment
  • Not thoroughly washing hands after touching animals

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What Can Be Done To Slow The Development Of Antibiotic Resistance In Bacteria

Aggressive action is necessary to slow the development of new resistance in bacteria and to prevent existing resistance from spreading. These actions can occur at multiple sources, from individuals seeking treatment and their healthcare practitioners, to health departments, health care facilities, regional laboratories, and government agencies. The following sections explain what is being done to combat antibiotic resistance and how you can help.

Why Resistant Pathogens Are Found In Ltcfs

In many ways, LTCFs are ideal settings for the emergence of resistant bacteria . The transfer of infected or colonized patients from acute-care facilities to LTCFs is probably the primary mode of introduction of resistant pathogens to this environment. A classic example of this is the spread of methicillin-resistant Staphylococcus aureus from acute-care facilities to nursing facilities . From the LTCF, resistant bacteria can be transported back to the acute-care facility or can find their way into the community . In addition, the excessive and inappropriate use of antibiotics in the nursing facility can select for mutations in bacterial gene that give the organism a selective advantage. Mutations in plasmid-encoded -lactamase genes that confer resistance to ceftazidime are a contemporary illustration of this . Once endemic, the antibiotic-resistance genes can be transferred from one patient to another and from one species or genus to another on mobile genetic elements .

This paradigm of the transfer of elderly patients within the health care system illustrates the movement of bacteria from one facility to another and to and from the community. SNF, skilled nursing facility.

Paradigm developed to evaluate for the presence of infection in elderly residents of long-term-care facilities. Figure is modified from . BP, blood pressure CBC, complete blood cell count CXR, chest radiography EKG, electrocardiography temp, temperature VS, vital signs.

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How To Avoid Antibiotic Resistance

Although antibiotic resistance refers to bacteria and to your body, there are still steps you can take to avoid contributing to it. One of the most important things you can do is to remember that not every infection needs to be treated with antibiotics. For example, infections such as the flu and colds are caused by viruses, not bacteria, and you shouldnt take an antibiotic for them.

Other steps you can take include:

  • Only take antibiotics when its really necessary, as prescribed by a doctor or healthcare professional
  • Dont take leftover antibiotics from an old prescription
  • Dont take an antibiotic that was prescribed to someone else
  • Take your antibiotic for exactly as long as prescribed, even if you feel better
  • Practice good handwashing habits by washing your hands often with soap and warm water
  • Stay home when youre feeling sick
  • Prepare and cook food on clean surfaces

Pandemics Disinfectants And Healthcare Systems

Microbiology – Bacteria Antibiotic Resistance

Increased antibiotic use during the COVID-19 pandemic may exacerbate this global health challenge. Moreover, pandemic burdens on some healthcare systems may contribute to antibiotic-resistant infections. On the other hand, a study suggests that “increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term”.Disinfectants such as in various forms of use of alcohol-based hand sanitizers, and antiseptic hand wash may also have the potential to increase antimicrobial resistance. According to a study, “Extensive disinfectant use leads to mutations that induce antimicrobial resistance”.

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What Accelerates The Emergence And Spread Of Antimicrobial Resistance

AMR occurs naturally over time, usually through genetic changes. Antimicrobial resistant organisms are found in people, animals, food, plants and the environment . They can spread from person to person or between people and animals, including from food of animal origin. The main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials lack of access to clean water, sanitation and hygiene for both humans and animals poor infection and disease prevention and control in health-care facilities and farms poor access to quality, affordable medicines, vaccines and diagnostics lack of awareness and knowledge and lack of enforcement of legislation.

Stop The Antibiotic From Reaching Its Target:

  • Pump the antibiotic out from the bacterial cell. Bacteria can produce pumps that sit in their membrane or cell wall. These so-called efflux pumps are very common in bacteria and can transport a variety of compounds such as signal molecules and nutrients. Some of these pumps can also transport antibiotics out from the bacterium, in this way lowering the antibiotic concentration inside the bacterial cell. In some cases mutations in the bacterial DNA can make the bacteria produce more of a certain pump, which in turn increases resistance.
  • Certain changes in the bacterial membrane make it more difficult to pass through. In this way, less of the antibiotic gets into the bacteria.
  • Destroy the antibiotic. There are bacterial enzymes that can inactivate antibiotics. One example is -lactamase that destroys the active component of penicillins, extremely important antibiotics for treating human infections. In later years, bacteria that produce extended-spectrum -lactamases, so called ESBL-producing bacteria, have become a major problem. They can degrade a wide spectrum of -lactam antibiotics, sometimes also the last resort drugs available for infections with these bacteria.
  • Modify the antibiotic. Bacteria can sometimes produce enzymes that are capable of adding different chemical groups to antibiotics. This in turn prohibits binding between the antibiotic and its target in the bacterial cell.

Figure 1.

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Why Is Antimicrobial Resistance A Global Concern

The emergence and spread of drug-resistant pathogens that have acquired new resistance mechanisms, leading to antimicrobial resistance, continues to threaten our ability to treat common infections. Especially alarming is the rapid global spread of multi- and pan-resistant bacteria that cause infections that are not treatable with existing antimicrobial medicines such as antibiotics.

The clinical pipeline of new antimicrobials is dry. In 2019 WHO identified 32 antibiotics in clinical development that address the WHO list of priority pathogens, of which only six were classified as innovative. Furthermore, a lack of access to quality antimicrobials remains a major issue. Antibiotic shortages are affecting countries of all levels of development and especially in health- care systems.

Antibiotics are becoming increasingly ineffective as drug-resistance spreads globally leading to more difficult to treat infections and death. New antibacterials are urgently needed for example, to treat carbapenem-resistant gram-negative bacterial infections as identified in the WHO priority pathogen list. However, if people do not change the way antibiotics are used now, these new antibiotics will suffer the same fate as the current ones and become ineffective.

The cost of AMR to national economies and their health systems is significant as it affects productivity of patients or their caretakers through prolonged hospital stays and the need for more expensive and intensive care.

How Antibiotic And Antifungal Use Affects Resistance

Antimicrobial resistance stock vector. Illustration of medicine

Antibiotics and antifungals save lives, but their use can contribute to the development of resistant germs. Antimicrobial resistance is accelerated when the presence of antibiotics and antifungals pressure bacteria and fungi to adapt.

Antibiotics and antifungals kill some germs that cause infections, but they also kill helpful germs that protect our body from infection. The antimicrobial-resistant germs survive and multiply. These surviving germs have resistance traits in their DNA that can spread to other germs.

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Antibiotic Resistance And ‘superbugs’

The overuse of antibiotics in recent years means they’re becoming less effective and has led to the emergence of “superbugs”.

These are strains of bacteria that have developed resistance to many different types of antibiotics, including:

These types of infections can be serious and challenging to treat, and are becoming an increasing cause of disability and death across the world.

The biggest worry is that new strains of bacteria may emerge that cannot be treated by any existing antibiotics.

Multiplicity Of Resistance Mechanisms In Producer Organisms

Most producer organisms contain several mechanisms for self-resistance. For example, S. peucetius relies on DrrAB to efflux doxorubicin , DrrC to remove the antibiotic from its target DNA , and DrrD is possibly used to modify the antibiotic to an inactive form . In addition, there is also a serine protease capable of sequestering daunorubicin to prevent its re-entry into the cell following efflux . Other examples of producers containing several mechanisms for self-resistance include the following: Microbispora ATCC PTA-5024 contains both an efflux pump and a sequestration protein to protect against NAI-107 S. rimosus has an ABC multi-drug efflux pump and an MFS pump for efflux of oxytetracycline along with OtrA to protect the ribosome by antibiotic removal S. fradiae contains several gene products that modify the ribosome to prevent tylosin binding and uses TlrC for efflux and S. chattanoogensis L10 contains several different efflux pumps for resistance against natamycin .

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What Is Antimicrobial Resistance

Antimicrobial Resistance 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 of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.

The Global Antimicrobial Resistance And Use Surveillance System

Antibiotic Resistant Bacteria

WHO launched the Global Antimicrobial Resistance and Use Surveillance System in 2015 to continue filling knowledge gaps and to inform strategies at all levels. GLASS has been conceived to progressively incorporate data from surveillance of AMR in humans, surveillance of the use of antimicrobial medicines, AMR in the food chain and in the environment. GLASS provides a standardized approach to the collection, analysis, interpretation and sharing of data by countries, territories and areas, and monitors the status of existing and new national surveillance systems, with emphasis on representativeness and quality of data collection. Some WHO regions have established surveillance networks that provide technical support to countries and facilitate enrollment into GLASS.

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What Are Antibiotic

Antibiotic-resistant bacteria are germs that can no longer be controlled or killed by an antibiotic medication. This resistance develops when bacteria change or alter in a way that makes antibiotics less effective.

Antibiotic resistance occurs naturally when bacteria evolve and develop defense mechanisms to survive a changing environment, but experts say that misuse of antibiotics is speeding up the process dangerously.

A growing number of bacteria are becoming resistant to antibiotics, including those that cause skin infections, urinary tract infections, meningitis, sexually transmitted diseases , and respiratory tract infections such as pneumonia.

To be clear, it’s the bacteria, not humans, that become antibiotic-resistant. In other words, antibiotic resistance does not mean that the human body becomes resistant to antibiotics. It means that the bacteria are resistant to antibiotics.

Who Is Most At Risk

Resistant bacterial infections can affect anyone, but some groups are at higher risk than others. These include people:

  • Undergoing chemotherapy
  • Receiving dialysis for end-stage renal disease
  • Receiving therapy that suppresses the immune system
  • With organ or stem cell transplants
  • Who are very young or elderly
  • Who are hospitalized

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What Are Some Examples Of Antibiotic Resistant Bacteria

In 2013, the CDC identified the top 18 antibiotic resistance threats in the United States. They classified resistance threats as urgent, serious, and concerning. Urgent and serious threats require more aggressive monitoring and prevention, while concerning threats require monitoring and response to occasional outbreaks. Concerning threats have a lower risk of occurring, or there are more therapies remaining for those infections. Some key examples from each threat level category follow below.

Transmission Of Antibiotic Resistant Bacteria In The Community

Resistance of Bacteria To Antibiotics Stock Illustration

Antibiotic resistant bacteria can also be passed from person to person within the community. This is becoming more common. Ways to prevent transmission of organisms, including antibiotic resistant bacteria, are:

  • Wash hands before and after food handling, going to the toilet and changing nappies.
  • Cover your nose and mouth when coughing and sneezing.
  • Use tissues to blow or wipe your nose.
  • Dispose of tissues properly, either in the rubbish or toilet.
  • Stay at home if you are unwell and cannot manage the normal requirements of your day.
  • Do not send children to child care, kindergarten or school if they are unwell.
  • If you are prescribed antibiotics, take the entire course do not stop because you are feeling better.
  • If you continue to feel unwell, go back to the doctor.
  • Avoid use of products that advertise they contain antibiotics, or are antibacterial or antimicrobial, unless advised to do so by your health professional.

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