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Opinion 'Antibiotic resistance is one of the biggest threats to human health'

Unless we take immediate action, we will soon enter a post-antibiotic world, writes Dearbhla Lenehan.

A RECENT PRESS release from the World Health Organisation (WHO) had some concerning news about gonorrhea. The sexually transmitted infection is becoming harder — and sometimes impossible — to treat, because of antibiotic resistance. The WHO data was collected from 77 different countries and three of them — Japan, France, and Spain — have shown untreatable strains of the STI.

Unfortunately, untreated gonorrhea can cause immense discomfort, infertility, ectopic pregnancies and in rare cases these infections can spread into the bloodstream and cause life-threatening damage to other parts of our bodies.

For a long time the idea of antibiotic resistant bacteria has seemed far-fetched or theoretical. When this topic is brought up the response is usually “they’ll find another drug or I’m sure something else will work.”

One of our most pressing problems

Unfortunately, at present, there are no alternatives. In 2015, a bacterium resistant to the “last resort” antibiotic colistin was identified for the first time in China. In 2016 similar findings were found in European countries. Earlier this year, an American woman died from an infection caused by a superbug resistant to every available antibiotic. Could this be the start of a superbug-killing spree?

Antibiotics save millions of lives but antibiotic resistance has been described as one of the world’s most pressing public health problems. Since 2000, there has been a steady increase in the prevalence of antibiotic resistant bacteria.

This led to the World Health Organisation publishing its first ever list of bacteria that urgently need new antibiotics earlier this year. Once easily treatable infections have now become extremely difficult if not impossible to treat leading to immense discomfort in patients and in some cases these infections can be fatal.

Misuse and overuse

Unfortunately, antibiotic resistance is increasing and is an issue that affects us all. How has this antibiotic resistance come about? Simply – misuse and overuse.

Every time you take antibiotics, sensitive bacteria are killed. Antibiotics place a selective pressure on bacteria and in a bid to survive bacteria can manipulate their genetic material or acquire pieces of DNA that code for the resistance properties from other bacteria.

Misusing antibiotics is taking antibiotics for a viral infection like a cold or flu; antibiotics can only treat bacterial infections and won’t help your flu. Another example of misuse is if you do not finish your full course of medication, or do not take it exactly as directed by your doctor. In this case, not all of your infecting bacteria are killed off and in a bid to survive and re-infect they begin to multiply and can find ways to acquire antibiotic resistance.

The farming industry

Overuse of antibiotics primarily occurs in the farming industry. In Ireland there are strict guidelines regarding the use of antimicrobials in farming. However, even with this, a report published by the Food Safety Authority of Ireland in 2015, found that there is still potential for antimicrobial resistance transmission to the food chain.

This transmission can occur if we eat meat that’s contaminated with antimicrobial-resistant bacteria, which is more likely in food from animals that received antimicrobial agents. It can also occur when animals treated with antibiotics urinate or defecate. Then traces of these antibiotics enter the soil and waterways where bacteria can gain resistance to them. These resistance genes can then be easily passed on to other bacteria and spread.

Bacterial-related illnesses affect the most vulnerable: the young, the old, those receiving chemotherapy and those undergoing organ transplants. Commonly, patients suffering from a completely different disease, sadly end up succumbing to secondary infections.

We should only take them when we need them

Unfortunately, as more and more bugs gain antibiotic resistance, it’s becoming increasingly difficult to help these patients. However, if we act now to inform ourselves about antibiotic use, only take them when we really need them and avoid their overuse, including in farming, we can slow down the emergence of these killer superbugs.

In 1945, Alexander Fleming, the discoverer of penicillin, said “the thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection by penicillin resistance”.

Unfortunately now, 72 years later, his words are becoming a reality. Antibiotic resistance is recognised as one of the greatest potential threats to both human and animal health worldwide. Without effective action, the severity of this treat will only heighten. Unless we take immediate action on a global scale to combat this, it seems inevitable that we will soon enter a post-antibiotic world.

Dearbhla Lenehan is an Infection Biology PhD student in University College Dublin and holds a BSc in Cell and Molecular Biology. She believes it’s extremely important to spread the message (and not the resistance) regarding sustainable and effective antibiotic use.

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