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There is a terrifying global threat, present and future, lurking in every corner of the planet. It is even much more worrying and harmful than malaria or HIV and yet it goes unnoticed by a large part of society. This is antimicrobial resistance (AMR), which occurs when changes in microorganisms cause drugs used to treat infections to become less effective.
A recent report estimates that bacterial antimicrobial resistance was associated with 5 million deaths in 2019, including 1,27 million directly attributed deaths. These figures place bacterial resistance to antimicrobials as one of the main causes of mortality worldwide.
More deaths than from traffic accidents
It is not a minor problem that only affects the most disadvantaged countries, far from it. More than 2,8 million antimicrobial-resistant infections occur in the U.S. each year, and more than 35 people die as a result. And in Europe 000 people die annually as a result of hospital-acquired infections caused by bacteria resistant to antibiotics. According to the latest data, 33 of these deaths are recorded in Spain, four times more than those caused by traffic accidents.
Furthermore, the Organization for Economic Cooperation and Development has estimated that the cost of bacterial resistance to antimicrobials, related to the health systems of the countries of the European Union, is around 1 billion euros annually and causes 100 trillion euros of loss of Gross Domestic Product (GDP).
The situation could get worse. According to the World Health Organization (WHO), if the trend continues, by 2030 antimicrobial resistance could push up to 24 million people into extreme poverty. And some forecasts predict that, if the scenario does not improve, in the year 2050 bacterial infections will be the main cause of mortality worldwide and a death toll of close to 10 million people will be reached each year, surpassing the number to traffic accidents, cancer and diabetes. In addition to reducing global annual GDP by 3,8%.
Why is it so devastating? In essence, because more and more common diseases are untreatable due to resistance, including respiratory tract infections, sexually transmitted infections and urinary tract infections.
The abuse of antibiotics in animal production is one of the triggers
Although the phenomenon of antimicrobial resistance is a natural process observed since first-generation antibiotics began to be applied against microbial infections, the persistent use of antibiotics, self-medication and exposure to infections in hospitals have accelerated the phenomenon. development of multiresistant bacteria.
There is strong evidence that the release of antimicrobial compounds into the environment, combined with direct contact between natural bacterial communities and resistant bacteria, is driving bacterial evolution and the emergence of more resistant strains.
The improper or excessive use of antibiotics in animal production is a worrying fact. Approximately 75% of antibiotics are not absorbed by animals and are excreted by the body through feces and urine, potentially contaminating and directly damaging the surrounding environment.
In Africa, the European Union and the United States, it is estimated that between 50 and 80% of all antibiotics are applied to animals, mainly to promote their growth and prevent bacterial infections. Estimates predict that antibiotics used in animals intended for human consumption will increase by 11,5% in 2030.
ESKAPE, the most dangerous sextet of bacteria
The problem of antimicrobial resistance does not extend uniformly to all bacteria. The Infectious Diseases Society of America (IDSA) identified six species as especially dangerous due to their virulence and possible multidrug resistance mechanisms. Grouped under the acronym ESKAPE, these are Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp..
This group of pathogenic bacteria seems to have a certain ease in “escape” from the bactericidal action of some antibiotics. Furthermore, the WHO has classified multidrug-resistant pathogenic bacteria into three priority groups: group 1 (critical priority), group 2 (high priority) and group 3 (medium priority).
Looking for new antibiotics
The lack of treatment against multidrug-resistant bacteria could take us back to a time when millions of people died from pneumonia or salmonellosis. Without effective antibiotics for the care and prevention of infections, the success of treatments such as organ transplant, chemotherapy or surgery would be compromised.
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Source: The Conversation. Authorship: Raul Rivas Gonzalez Professor of Microbiology, University of Salamanca
Featured Image: Source Pexels.com, Photo by Karolina Grabowska
