Following the discovery of penicillin in 1928, a whole new region of public health had begun to unfold. The impact of the antibiotic, penicillin, expanded upon the treatment of infectious diseases to an incredulous degree. However, since their introduction, millions of metric tons of antibiotics have been manufactured and produced. This large-scale production released many toxic substances into the atmosphere, which caused the evolution and mutation of microbes.
By the mid 20th century antimicrobial-resistant pathogens were growing at a rapid scale. Antibiotics had been used in agriculture, livestock and healthcare to an indiscriminate amount, which only accelerated the spread of resistant microbes. The need for antimicrobials wasn’t decreasing and the resistance from microbes was only increasing. To combat that issue, new antimicrobials were produced. The continuous misuse of antimicrobials caused the same outcome to come from these new varieties. In Europe alone, it had been observed that 700,000 reports of infections had become resistant to antimicrobials. These infections then turned deadly and contributed to 33,000 deaths annually.
What are antibiotics?
Antimicrobials are medicines that are used to treat infectious diseases. All these antibiotics come in different forms, but they all serve the same baseline purpose. That is to get rid of microorganisms that have infected an individual, compromising their health and well-being. There are antibiotics for bacterial infections, antivirals for viral infections, antifungals for fungal infections and antiparasitics for parasitic infections.
Antimicrobials have been one of the leading foundations of modern medicine. It has given us the tools needed to treat and prevent many diseases that ravage the human, animal and plant populations. Now, with microorganisms becoming resistant to these drugs, it is vital we find a way to hinder this certainly catastrophic development.
Antimicrobial resistance is something that occurs over some period of time. It can be accelerated by overuse or misuse of drugs. The microbes that were once easily eradicated evolve and change their biology to one where the drugs no longer affect them. It’s very clear how much of a problem this may cause to everyone, regardless of background.
Challenges
For starters, antimicrobial resistance will affect the health of all humans on Earth. These microbes continuing to evolve and grow means they become deadlier to us. With their newfound resistance to antimicrobials they can quickly infect a person and spread to others even quicker. The people infected would require more precise treatment that may not be affordable to everyone. Without treatment, people stay sick and stay home, which is just one way in which the world’s economic development can be hindered. Over time, the ones that aren’t in a fortunate position financially would succumb to their inevitable death.
The mortality rate of young children, the elderly and infants would increase as their immune system isn’t as well developed or sturdy. Lesser children would make it to adulthood. This would greatly hurt the global economy as the working population starts retiring. Infections and diseases would easily spread amongst these vulnerable populations and without access to proper and affordable healthcare, a lot of them would end up dead.
Microbes also infect animals and plants, and they too, have an antimicrobial resistance issue. If the development of the microbes continues in an upward direction, many crops and animals will die. In the case of human to animal contact, if the microbes evolve enough and can find a way to jump species, this would potentially put many other animals and humans in danger. Wild animals might start facing endangerment. Domesticated animals would be lost in large numbers and our food supply would dwindle. Plants would become scarce and crops would die. This will greatly hurt the economy and bring a wave of food insecurity. This wave would also cause the emergence of a tremendous spike in the cost of everyday groceries, leading many to struggle to have their 3 daily meals met.
The economy will take a massive hit as well. Our ability to treat infections and lifesaving operations would be greatly affected. Chemotherapy, caesarean section and hip replacements are just a few examples. These operations are very costly and there are many patients that simply will not be able to afford them. Some places might lose the facilities to treat and conduct such operations as it becomes too risky without enough financial support. With the microbes becoming stronger, it becomes riskier, possibly even life-threatening to perform these operations.
Present situation
As of 2022, it has been reported that 76 countries have had a 42% increase in antibiotic resistance from 3rd generation cephalosporin E-coli and a 35% resistance from methicillin Staphylococcus aureus. Urinary tract infections caused by E-coli have been found to have a 1 in 5 chance of being resistant to the antibiotics. Klebsiella pneumoniae has also shown signs of resistance against last resort critical antibiotics. This increase in resistance to last resort antibiotics leaves us in a position where there are no longer any other options left for treatment of the illness. It has been predicted that by 2035, microbial resistance to last resort antibiotics will double in comparison to its resistance in 2005.(World Health Organization (WHO))
Fungal infections, HIV, tuberculosis, and malaria are some of the diseases that have been affected by antimicrobial resistance. With the microbes becoming increasingly resistant to the antibiotics, it leaves very few treatment options for the people suffering from an infection of this degree. If these resistant microbes continue to spread, these and many other illnesses will soon become a major public health and safety concern.
Leprosy medicines, dapsone, rifampicine, clofazimine, anti-helminthics, African trypanosomiasis, and leishmaniasis. These are a list of neglected tropical diseases(NTDs) that have greatly affected vulnerable and marginalized communities with this wave of antimicrobial resistance. With the lack of proper treatment, the microbes have been able to evolve and become resistant to antibiotics.
The pace at which antimicrobial drugs are being developed is severely slow in comparison to the speed at which microbes are becoming resistant to these drugs. By 2050 it is predicted that about 10 million deaths will result annually due to diseases in which their microbes have become resistant to antibiotics. Common illnesses will become deadly and risky treatments and surgical procedures will become even deadlier.
Cause of the resistance
- An overuse of antibiotics can contribute to the resistance of microorganisms to them. Only take antimicrobials when prescribed by your doctor or health provider.
- Misuse of antimicrobials also greatly enhances microbial resistance. Not finishing a dose can be dangerous and may end up not killing the microorganism, just weakening it. Once you have stopped taking the medication, when your dose hasn’t ended, the microbe will be able to slowly regain its strength and evolve to become resistant to that medication altogether. Taking drugs that are not yours can also be categorized under misuse and will affect the microbes in a variety of different ways.
- The genetic makeup of a microbe might spontaneously change, which in turn makes it resistant to any antibiotic that may have been able to eradicate it previously.
- It is also possible to gain a drug-resistant microbe through an infected person. Once the drug-resistant microbe evolves in the infected individual, it may be able to easily find its way to other people, infecting them with a new wave of evolved microbes.
Superbug
There are a group of microorganisms that seem to be completely resistant to the effects of antimicrobials. They continue to multiply and infect, surpassing the efforts of the antimicrobials completely. These microbes are termed “superbugs”. A couple examples include Clostridioides difficile, drug-resistant gonorrhea, methicillin-resistant Staphylococcus aureus, multi-drug-resistant Mycobacterium tuberculosis, and vancomycin-resistant Enterococci. (Professional, C. C. M.)
Immune response
There are 2 responses to an infectious disease entering the body, the clinical and the immunological. The immunological, in the case of polio, can start off as simple as the virus taking shelter in the throat and intestine of the patient. For some people the virus will simply be ejected from the body through the throat or bowel in the period of a couple weeks. By the end of those weeks the polio virus will be completely gone. In the weeks that the virus is being ejected, the body’s immune system will have created memory cells, which are a subset of white blood cell T cells. These memory cells will now contain an anti-poliovirus response so that anytime the virus enters again, the immune system will be able to remember exactly what virus that is and eradicate it immediately.
In some individuals, the polio virus will gain entry into the bloodstream, where it will circulate before eventual elimination. In others, the virus will go from the bloodstream into the central nervous system. It will circulate for a while before it is eliminated. In a few rare cases, the viruses that enter the central nervous system will damage some nerves responsible for movement. This will eventually cause paralysis in the patient. Individuals infected with poliovirus barely have any symptoms to show for it. The only ones that may appear include a slight headache and a sore throat before the virus is eventually fully discharged.
Every species on earth has, to some extent, a natural inbuilt immunity. Some may have it more than others, and some species have different immunity for different diseases. Within one species, for instance humans, you might find that some people are more resistant to certain diseases. This can happen for a variety of reasons. The environment in which those particular groups reside, the food that they eat, and their proximity to certain animals or plants carrying certain diseases are all major contributing factors to their immunity. Repeated exposure to a certain microbe may leave certain groups more resistant to the disease that the microbe carries, making them immune.
The human skin has a natural resistance to a large amount of microorganisms. In the case that a microbe does gain entry into the bloodstream, the immune system works hard to ensure it is eliminated before it can cause any damaging, long-lasting effects on the body. A type of white blood cell called granulocytes are constantly being circulated throughout the body. Once an invasive pathogen enters, the granulocytes gather around it and engulf it.
Immunization
To simulate immunization, a weakened version of the infectious pathogen is injected into the body. Its state renders it harmless to the body. The body then releases antibodies to fight against the weakened pathogen and make memory cells. These cells will remember it in the chance that the body gets infected with the real full-strength pathogen. This is the process of vaccination.
Antibodies created in one body can be transferred to another to help fight a foreign pathogen. This, however, is short-lived for the antibody itself is registered as foreign by the body. Newborn babies are a great example of recipients of antibodies through the placenta from the mothers immune system. Once they have reached around 1 year of age the borrowed antibodies start being expelled, and they now must receive vaccination for some particular diseases to avoid falling seriously ill with them.
Solutions
Artificial intelligence(AI) has shown great progress in optimizing the treatment plans based on a thorough examination of patterns in microbes that may have been causing them to become so easily resistant to certain antimicrobials. Machine learning presents a great opportunity for better understanding and amplification of precision medicine so that we may eradicate the chance of microbes ever gaining the opportunity to evolve and become resistant to medication. AI can also be used to enhance the quality of medication for each individual patient by ensuring they receive the best treatment plan for them. All these developments seem to lead to a promising future for medicine and public health, but AI is yet to reach that level of complex understanding and data analysis.
New drugs can always be developed to help combat the antimicrobial resistance issue. Though there are a couple down-sides to that. Making new medication will take a lot of time, money, resources and continuous experimentation. That is simply not ideal in the case of a rapidly growing disease. There are many illnesses that show us how time is of the utmost essence. If not treated within a prescribed period, many will perish. There are other diseases that spread incredibly quickly. All these are just some of the downsides that may present themselves when attempting to create new antimicrobial medication to hopefully replace the ones that are now rendered useless.
One way in which we can possibly combat antimicrobial resistance is by a method of combined therapy. This is where multiple different drugs, that serve different purposes, are served together to one patient to rid them of the disease. This approach will most likely work tremendously well, but there are many adverse side effects that may befall a person for taking so many different drugs at the same time.
Arguably, the most effective way to rid ourselves of these antimicrobial-resistant microbes is to educate the public. To carefully survey the effects of these drugs on the general population helps us to better understand the treatments that yield the best results while simultaneously causing as little microbial resistance as possible. Educating the public about safe use of medication and the dangers of overuse will greatly curb the devastating effects of antimicrobial resistance in the future. Keeping the public aware of these changes and challenges allows affordable medication to stay effective and in the market.
Conclusion
Antibiotics are vital for the continuity of life. From normal everyday infections to advanced surgical procedures, they prevent countless ailments. It is essential that we take precise measures and educate ourselves and the people around us on the importance of the proper use of antimicrobials. Learning of its proper disposal will help us avoid further contaminating the earth and evolving microbes while simultaneously destroying the life around us. Taking the necessary preventative measures will help us contain and avoid the otherwise unpleasant atrocity that would be the future of our health and well-being.
Bibliography
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