Context: Antimicrobial resistance: the silent threat . Tackling the problem would mean engaging the health, agricultural, trade and environment sectors.

• Antimicrobial resistance (AMR) is a growing global problem to which the ongoing Covid-19 pandemic may further contribute.

Key Points

• Anti microbial resistance is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics) that are used to treat infections.
• As a result, standard treatments become ineffective, infections persist and may spread to others.
• Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
• Antimicrobial resistance is now regarded as a major threat to public health across the globe.

How it Happens

• Some bacteria due to the presence of resistance genes are intrinsically resistant and therefore survive on being exposed to antibiotics.

Bacteria can also acquire resistance. This can happen in two ways

• by sharing and transferring resistance genes present in the rest of the population or
• by genetic mutations that help the bacteria survive antibiotic exposure.
• Once the resistance has been acquired, it can spread in the rest of the population of bacteria through reproduction or gene transfer.

Reasons for Spread of AMR
Antibiotic consumption in humans

• Unnecessary and injudicious use of antibiotic fixed dose combinations could lead to emergence of bacterial strains resistant to multiple antibiotics.

Social factors

• Include self-medication.
• Access to antibiotics without prescription.
• Lack of knowledge about when to use antibiotics.

Cultural Activities

• Mass bathing in rivers as part of religious mass gathering occasions.
• Antibiotic Consumption in Food Animals
• Antibiotics which are critical to human health are commonly used for growth promotion in poultry.

Pharmaceutical Industry Pollution

• The wastewater effluents from the antibiotic manufacturing units contain a substantial amount of antibiotics, leading to contamination of rivers and lakes.

Environmental Sanitation

• Untreated disposal of sewage water bodies – leading to contamination of rivers with antibiotic residues and antibiotic-resistant organisms.
• Infection Control Practices in Healthcare Settings
• A report on hand-washing practices of nurses and doctors found that only 31.8% of them washed hands after contact with patients.

Road Ahead

• Efforts to control prescription of antimicrobials should be accompanied by efforts to educate consumers to reduce inappropriate demand, issue standard treatment guidelines that would empower providers to stand up to such demands, as well as provide point-of-care diagnostics to aid clinical decision-making.