Antimicrobial Resistance (AMR) develops gradually over time usually through genetic modifications. The main causal agents, antimicrobial-resistant organisms are ubiquitous, they can be found in humans, animals, food, plants, and the environment (in water, soil, and air), transmitted from person to person or between people and animals, particularly through animal-derived food. AMR is a global threat and its impact is even worse on low-income and lower-middle-income countries such as countries in Sub-Saharan Africa.
Well, I'm not here to tell you what you already know, but I'd like to ask a few questions, the irony in the use of antimicrobials is now so obvious. Why do we have children under the age of 5 with at least three (3) different classes of antimicrobials that are ineffective? In a study in western Kenya by Tornberg-Belanger et al., 2022, the frequency of AMR in E. coli from children who have been hospitalised and then discharged is significant. Strategies to stop and reduce AMR transmission and acquisition in the healthcare setting are therefore desperately required, as healthcare exposure is the leading cause of AMR transmission and acquisition.
What is the risk-benefit ratio of antimicrobial use?
The infections they’re supposed to treat not only get neglected but also become a bigger issue. Antimicrobials that are supposed to be used for the eradication of microbial mayhem are now the main agents actively involved in the development of its potent-resistant strains due to indiscriminate or misuse.
High rates of resistance have been observed globally against antibiotics commonly used to treat common bacterial infections, such as urinary tract infections, sepsis, sexually transmitted infections, and infectious diarrhoea, indicating that we are running out of effective antibiotics. What's the cost implication on an average citizen? Cheaper first-line alternatives become useless calling for expensive ones as a last resort
Resistance to fluoroquinolones and β-lactam antibiotics often considered the first line for empirical therapy of severe infections is responsible for a large number of deaths attributable to AMR across pathogens. Over the years, mortalities, and severe comorbidities have been encountered on otherwise easy-to-treat infections due to resistance.
At least we still have expensive and other classes that are still being used, what happens when it all fails? A single person is enough to make a whole community subjected to this resistance menace just by passing a single strain of a resistant microbial infection.
The problem lies far beyond a single individual indiscriminate use or practice, it has become a hydra-headed problem that cutting the tail will only allow another part to grow. The basic principle to ensure complete eradication is complete prevention, AMR preventive procedures should be implemented and taken seriously. Unless good measures are in place to cure all infections in a practical sense, we're looking forward to a microbial apocalypse!
~Durojaye Aishat Bisoye
