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Antimicrobial resistance

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Antimicrobial resistance, or AMR, is a biological phenomenon where microbes evolve mechanisms to protect themselves from drugs. These medicines, known as antimicrobials, are essential for treating infections in humans, animals, and plants. AMR is an umbrella term covering several specific types of resistance. It includes antibiotic resistance in bacteria, antiviral resistance in viruses, antiparasitic resistance in parasites, and antifungal resistance in fungi.

WhatIsDrugResistance
WhatIsDrugResistance

When microbes become resistant, the drugs that once killed them become ineffective. This makes common infections much harder to manage and increases the risk of severe illness or death.

Resistance occurs through several distinct biological pathways. One common way is through spontaneous genetic mutation. During cell division, a microbe may experience a random change in its DNA. If this mutation allows the microbe to survive exposure to a drug, it will continue to multiply. Another method is horizontal gene transfer, where microbes share resistance genes with one another. They can do this through conjugation, transduction, or transformation.

Antibiotic resistance mechanisms
Antibiotic resistance mechanisms

This allows resistance to spread rapidly, even between different species of bacteria. Resistance can also be categorized as microbiological or clinical. Microbiological resistance involves specific genes that block a drug's mechanism. Clinical resistance is observed when a treatment fails to work during a patient's therapy.

While resistance can occur naturally over time, human activities greatly accelerate the process. The misuse and overuse of antimicrobials are primary drivers of this trend. In some regions, up to one in three antibiotic prescriptions may be unnecessary. For example, approximately 46 million out of 154 million annual antibiotic prescriptions are considered inappropriate. Overprescribing in both human medicine and agriculture increases the selective pressure on microbes. This pressure favors the survival of resistant strains.

Antibiotic Resistance Spread
Antibiotic Resistance Spread

Additionally, when patients stop taking their medication early, the most resilient microbes may survive and reproduce.

Scientists use specific protocols to identify these resistant microbes in a laboratory. One common method is the Kirby-Bauer disk diffusion susceptibility test. In this test, bacteria are spread onto a solid medium in a Petri dish. Paper disks containing different antibiotics are placed on the surface.

Antibiotic sensitivity and resistance
Antibiotic sensitivity and resistance

If the bacteria are not resistant, they will not grow near the disks, creating clear rings. If the bacteria are resistant, they will continue to grow right up to the edge of the disk. Microbes that can resist many different types of drugs are called multidrug-resistant, or MDR. They are sometimes referred to as superbugs.

The global impact of AMR is a major public health crisis. In 2019, bacterial AMR was directly responsible for 1.27 million deaths worldwide. It also contributed to nearly 4.95 million total deaths that year. One in five people who died due to AMR were children under the age of five. The World Health Organization warns that annual deaths could reach 10 million by the year 2050.

Antibiotic resistance infographic by CDC
Antibiotic resistance infographic by CDC

The burden varies by region. Sub-Saharan Africa sees 23.7 deaths per 100,000 people, while North Africa and the Middle East see 11.2 deaths per 100,000.

Addressing this issue requires a complex, multi-sectoral strategy known as the One Health approach. This framework recognizes that human health, animal health, and environmental health are interconnected. Resistance can spread through agricultural runoff, wastewater, or the improper disposal of medicine. These substances enter soil and water systems, affecting the entire ecosystem.

Antibioticresistance diagram
Antibioticresistance diagram

To fight AMR, we must coordinate efforts across governments, farmers, and healthcare workers. This includes improving hygiene, developing new vaccines, and ensuring better access to necessary medicines in developing nations.

Without significant action, the world may enter a "post-antibiotic era." In this era, many common infections could become untreatable. Even vital medical procedures like surgery, organ transplants, and cancer treatments could become much riskier. Because new antibiotics are not being developed fast enough, the gap between infection and treatment is growing. Managing AMR is not just a medical challenge, but a global necessity for food security and economic stability.

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File:Antibiotic sensitivity and resistance.jpg
Antibiotic sensitivity and resistance.jpg
File:WhatIsDrugResistance.gif
WhatIsDrugResistance.gif
File:Antibiotic Resistance Spread.jpg
Antibiotic Resistance Spread.jpg
File:Antibiotic resistance infographic by CDC.jpg
Antibiotic resistance infographic by CDC.jpg
File:Perron_2015_permafrost_antibiotic_resistances.png
Perron_2015_permafrost_antibiotic_resistances.png
File:Antibioticresistance diagram.png
Antibioticresistance diagram.png
File:mecA Resistance.svg
mecA Resistance.svg
File:Antibiotic resistance mechanisms.jpg
Antibiotic resistance mechanisms.jpg
The global resistome based on...
Gene-sharing network between bacterial genera.webp
File:Antibiotic sensitivity test.jpg
Antibiotic sensitivity test.jpg
Why won’t antibiotics cure us anymore.webm
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