Antimicrobial resistance is one of the biggest problem which a modern man is going to face. First of all we have to know what is antimicrobial and antimicrobial resistance
Antimicrobial agent is any drug destroys or inhibits the growth of microorganisms and especially pathogenic microorganisms.
Antimicrobial resistance occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. The term antibiotic resistance is a subset of AMR, as it applies to bacteria that become resistant to antibiotics
why this topic is important why we have to control antimicrobial resistance and how it develops?
Antimicrobial resistance occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. The term antibiotic resistance is a subset of AMR, as it applies to bacteria that become resistant to antibiotics.
Disease agents are treated by anti microbials and it started with the discovery of pencellne.
Now a days, simple microbes have developed resistance and are not treated with previous antibiotics.
Everyone is well aware of a term about salmonellosis or typhoid fever that it is drug resistance typhoid. it means that it is not responding to conventional antibiotics and floroquinolones are failing for 1st time to treat typhoid as they were drug of choice against typhoid. similarly, every pathogens is developing resistance against the antibiotic used for it conventionaly.
it is estimated that speed at which microbes are developing resistance against antibiotics is greater than the speed at which the new antibiotics are discovered and developed.If we didn't care simple diseases will pose threat of life . According to WHO, In 2050 the leading cause of death will be antimicrobial resistance.
How Antimicrobial Resistance develop?
Complications in the treatment of bacterial infections are increasing alarmingly because of resistance develop against the antimicrobial agents used. Antimicrobial agents varries according to the mechanism of action.
Mechanisms include;
1. lnterference with cell wall synthesis
2. lnhibition of protein synthesis
3. Interference with Nucleic Acid synthesis
4. lnhibition of metabolic pathways
5. Disruption of bacterial membranes structure
Antimicrobial resistance may be intrinsic or acquired. This could be because of mutation, acquisition of resistant genes, production of enzymes that destroy the antimicrobial agents, hinderance in reaching into the target site and many more reasons.
Pseudomonas are among the most commonly found bacteria in our surroundings, causing infections when found suitable conditions. Usually infections caused by pseudomonas are not much serious but antibiotic resistance of pseudomonas cause them a point of consideration.
Currently used anti pseudomonal agents include Beta-Lactams , Aminoglycosides and Flouroquinolones.
Beta-lactams are used in combination with other antibiotics to treat infections caused by pseudomonas. Mechanism of action of beta-Lactam group against P.aeuroginosa is by blocking bacterial peptidoglycan (PG) biosynthesis. Antibiotic agents used for this purpose are penicillins , cephalosporins, monobactams and carbapenems.
Pseudomonas aeruginosa is among the top notorious bacteria having resistance against antibiotics. As it's understood that resistance could be possibly intrinsic or acquired. These bacteria have both mechanism to fail antibiotics results.
Change or Destroy Antibiotic: P.aeruginosa just like Enterobacteriaceae species has AmpC beta-lactamase enzyme. There are many acquired beta-lactmases and aminoglycoside modifying enzymes and similarly almost twenty type of enzymes which cause resisitance against antibiotics that are noted in pseudomonas cells. Among these enzymes Class C chromosomal enzyme is seen to be the basic reason behind resistance. This beta-lactmase enzyme in encoded by gene AmpC interlinked with gene of derepression ampR gene. The combination of ampC-ampR cause resistance against antibiotics. These genetic chromosonmal mutation is acquired by the host and transferred to the next generation which cause daughter cells more resistant. P.aeruginosa can acquired Class A, B, D and beta-lactmases.
Class A include broad spectrum pencillinases which show homology. Class B include beta-lactmases, which hydrolyze beta-lactam antibiotics.
Altered outer membrane permeability: Pseudomonas species shows resistance by limiting the entry of antibiotics. OprD porin is a channel by which amino acids and antibiotics enter the cell. Deficiency of these porins(porin deficient mutant) alongwith presence of bewta-lactmase enzyme make the cell resistant. It is notified that this mechanism is interlinked with presence of beta-lactmase enzymes.
Get rid of Antibiotics: Pseudomonas aeruginosa shows resistance by it's impermeability-mediated resistance. It's just like a pump system which causes efflux of beta-lactams, chloramphenicol , Flouroquinolones, macrolides, novobiocin, sulfonamides, tetracycline and trimethoprim. Impermeability-mediated resistance is carried out through three component efflux pump. In the membrane of P.aueroginosa, the pump itself lies in the cytoplasm and connected to exit portal via linker lipoproteins. Lactams and Flouroquinolones are commonly resisted by the act of permeability mutation.
Excessive use of beta lactams in medical, veterinary and agriculture field , make bacteria resistance to them. Its more alarming than the infection itself. Selection of antibiotic in any bacterial infection should be by proper means to reduce this affect.
How to control?
Anti-infection opposition is quickened by the abuse and abuse of anti-toxins, just as helpless contamination anticipation and control. Steps can be taken at all degrees of society to lessen the effect and breaking point the spread of obstruction.
People
To forestall and control the spread of anti-microbial obstruction, people can:
Possibly use anti-toxins when recommended by a guaranteed wellbeing proficient.
Never request anti-toxins if your wellbeing laborer says you needn't bother with them.
Continuously follow your wellbeing specialist's recommendation when utilizing anti-infection agents.
Never offer or utilize extra anti-microbials.
Forestall diseases by consistently washing hands, getting ready food cleanly, evading close contact with wiped out individuals, rehearsing more secure sex, and staying up with the latest.
Plan food cleanly, following the WHO Five Keys to Safer Food (keep perfect, separate crude and cooked, cook altogether, guard food at temperatures, utilize safe water and crude materials) and pick food sources that have been created without the utilization of anti-toxins for development advancement or infection anticipation in solid creatures.
Strategy producers
To forestall and control the spread of anti-toxin obstruction, strategy creators can:
Guarantee a vigorous public activity intend to handle anti-infection obstruction is set up.
Improve reconnaissance of anti-infection safe diseases.
Fortify strategies, projects, and usage of disease counteraction and control measures.
Control and advance the proper use and removal of value prescriptions.
Make data accessible on the effect of anti-toxin obstruction.
Wellbeing experts
To forestall and control the spread of anti-infection obstruction, wellbeing experts can:
Forestall contaminations by guaranteeing your hands, instruments, and climate are perfect.
Possibly recommend and apportion anti-infection agents when they are required, as per current rules.
Report anti-infection safe contaminations to reconnaissance groups.
Converse with your patients about how to take anti-infection agents effectively, anti-toxin obstruction and the perils of abuse.
Converse with your patients about forestalling contaminations (for instance, immunization, hand washing, more secure sex, and covering nose and mouth when wheezing)
