Pharmacology: Drug Action Study Journal

Editorial

Global Spread of Antibiotic Resistance Renders Current Antibiotics Infective

Reza Nassiri*

Departments of Pharmacology and Toxicology, and Family and Community Medicine, MSUCOM, Michigan State University, East Lansing, Michigan, USA

Received: 12 June 2019

Accepted: 14 June 2019

Version of Record Online: 04 July 2019

Citation

Nassiri R (2019) Global Spread of Antibiotic Resistance Renders Current Antibiotics Infective. Pharmacol Drug Action Study J 2019(1): 01-02.

Correspondence should be addressed to
Prof. Reza Nassiri, USA

E-mail: Reza.Nassiri@hc.msu.edu
DOI: 
10.33513/PDAS/1901-01

Copyright

Copyright © 2019 Reza Nassiri. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and work is properly cited.

It’s been estimated by 2050, ten million people could die each year from diseases that have rendered resistance to antibiotics [1]. The World Health Organization and the UN warn common diseases are becoming untreatable by current antibiotics that exist in international market due to overuse irrational and overuse, of antibiotics in the treatment of humans, animals, plants and fisheries. Global consumption of antibiotics has increased by nearly 40% in the last decade [2]. The incredible rapid resistance of antibiotic resistance which is taking place worldwide is not only a serious threat to the practice of modern medicine, but equally important, a threat to global public health. This urgent issue is so alarming that it caught the attention of the G-20 Summit in both China (2016) and Germany (2017), let alone the UN Assembly in 2016 had called for a special meeting of “superbugs” which focused on the escalating drug resistance with respect to the sexually transmitted disease gonorrhea and carbapenem resistant Enterobacteriaceae [3]. While the causes of antibiotic resistance are complex, certainly human behavior play a significant role in the spread of antibiotic resistant genes. In addition to the human behavior, the drivers of resistance include agriculture sector, animal husbandry, household and industry - these factors contribute significantly to the spread of the resistant genes within the ecosystem. Such resistant mechanisms are continuously emerging globally, which threatens our ability to treat common infections, resulting in increased death, disability and costs. Since the development and clinical use of penicillin’s, nearly 1000 resistant-related beta-lactamases that inactivate various types of antibiotics have been identified. There is also a global concern about the emergence of antibiotic resistant carried by the healthy individuals, the commensal bacteria. The CDC and WHO surveillance data shows that the resistance in E. coli is generally and consistently the highest for antibacterial agents in both human and veterinary medicine [4,5]. Within communities, resistant bacteria circulate from person to person or from animals and environment to person, or vice versa. With one billion people traveling each year, bacteria are becoming more mobile. The bacterial resistance can kill 700,000 worldwide each year and it’s been estimated to kill 10 million by 2050. The WHO estimates 78 million people a year get gonorrhea, and STD that can infect the genitals, rectum and throat - there is a widespread resistance to the first-line medicine ciprofloxacin as well as increasing resistance to azithromycin. The emergence of resistance to last-resort treatments known as Extended-Spectrum Cephalosporin’s (ESCs) is now eminent. The five riskiest superbugs are recognized as the original one: Staphylococcus Aureus (MRSA); the hospital lurkers: Clostridium Difficile and Acinetobacter; the foodborne pathogens: Escherichia Coli and Salmonella; the sexually-transmitted infections: Gonorrhea and Chlamydia; and TB. India is a typical example of encountering the deadly bacterial resistance. The discovery of the New Delhi Metallo-beta-lactamase-1 (NDM-1) which disables almost all antibiotics directed against it, was turning point in the rapid emergence of blaNDM-1 gene which was first identified in 2008 in people who had traveled in India or sought medical care in South Asia [6]. The gene for NDM-1 travels on a plasmid, an extra-chromosomal loop of DNA that can be traded freely among bacteria. So far, it has been found a variety of bacterial species that carry NDM-1 particularly in the gut bacteria, which can cause serious infections in vulnerable hospital patients in India, South Asia, South Africa and the UK. There are two major routes of spread for the bacteria; hospital and the community. In hospital infections, bacteria carrying NDM-1 move from person to person when patients who have received many antibiotics, develop diarrhea and traces of feces contaminate surfaces, equipment and healthcare workers’ hands. In community infections, the bacteria carrying the enzyme passes from person to person when traces of feces contaminate municipal water supplies - and with a large percentage of the population lacking any access to sanitation. Public Health Foundation of India believes that 60,000 infants per year are dying of drug-resistant infections due to NDM-1. In addition, tourists can pick up antibiotic-resistance genes in just 2-3 days. Currently, India is facing with two antibiotic resistant genes what carry NDM-1; E. coli and Klebsiella. The discovery mrc-1 gene in China which is being transferred between Klesbsiella pneumonia and E. Coli further compounded the global burden of antibiotic resistance, which has already spread to the neighboring countries [7]. In the animal husbandry and agricultural sectors of China, the demand for the antibiotics to reach almost 12,000 tons per year. The high prevalence of the mrc-1 gene in E. Coli samples both in animals and raw meat, with the number of positive-testing samples are increasing each year in China. On average, more than 20 percent of bacteria in the animal samples and 15 percent of the raw meat samples carried the mrc-1 gene. Numerous European countries have reported the existence of mrc-1 gene in the isolates from human, isolates from animals used for food, isolates from food, and isolated from the environment. In summary, the global threat of antibiotic resistance necessitates the role science-in-action, which is tied up in scientific cooperation between world class research universities, in particular the role of departments of medicinal chemistry and pharmacology, and, global pharmaceutical companies. Therefore, there is an urgent need between research universities and industry aimed at developing novel antibiotics to save the practice of modern medicine [8]. To reach the milestone of such a goal for drug discovery and development may take several years when the big pharma takes over that must go through several phases of drug safety, efficacy, and clinical trials. It must also be recognized that antibiotic resistance is a serious threat that must be addressed urgently to save lives. Thus, collaborative efforts mentioned earlier are essential; however, health sectors such as government and other stakeholders can play pivotal role in catalyzing and supporting the collaborative efforts between research universities and the pharmaceutical companies [9]. While such a scientific approach to discovery and development of new antibiotics with lesser degree of resistance profile is ongoing, public health interventions to control the current antibiotic resistance issue is highly relevant and appropriate. The public health departments are encouraged to develop and implement policies and programs aimed at stopping the speared of antibiotic resistance especially in the communities where it is very prevalent. Such an effort must also identify and address the behavioral, environmental and clinical care factors that have led to the spread of antibiotic resistance. In addition, public health departments can play significant role working with other scientific communities to tackle the challenges of antibiotic resistance.

References

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  2. Lee Ventola C (2015) The Antibiotic Resistance Crisis. P&T 40: 277-283.
  3. CDC (2016) United National (UN) General Assembly on Antimicrobial Resistance. Centers for Disease Control and Prevention, USA.
  4. WHO (2014) Antimicrobial resistance: global report on surveillance 2014. WHO, Geneva, Switzerland.
  5. CDC. Antibiotic/Antimicrobial Resistance (AR/AMR). Centers for Disease Control and Prevention, USA.
  6. Yong D, Toleman MA, Giske HS, Cho HS, Sundman K, et al. (2009) Characterization of a new metalo-β-lactamase gene, bla (NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother 53: 5046-5054.
  7. Liu YY, Wang Y, Walsh TR, Yi LX, Zhang R, et al. (2016) Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biology study. Lancet Infect Dis 16: 161-168.
  8. Fair RJ, Tor Y (2014) Antibiotics and Bacterial Resistance in the 21st Century. Perspect Medicin Chem 6: 25-64.
  9. Global Antibiotic Resistance Market Size, Industry Report, 2018-2025. Grand View Research, Inc. USA.
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