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Are you a fan of zombie entertainment? In zombie post-apocalyptic
stories, usually the human population is wiped out by a deadly infection caused
by a viruses or a bacteria that spread quickly through populations. These tales
may not be fantasy much longer, thanks to the terrifying reality of
antimicrobial resistance.
The World Health Organization (WHO) recently released a
report summarizing the very real, very serious, threat of antimicrobial
resistance. It is a broad concern across the world, as it can spread easily
between countries. Governments are starting to notice its ability to undermine
modern medicine. Common infections and minor scrapes could become deadly within
the 21st century if we don’t act fast.
What are antimicrobial agents and how do they work to protect us?
Microbes are a more scientific word for germs, which are
made up of bacteria, viruses, and parasites. Antimicrobial agents are substances, usually in the form of drugs, vaccines,
and chemicals, that kill or slow the growth of microbes.
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Modern medicine has made it possible for antibiotics and antibacterial drugs work to kill bacteria
without harming human cells. They identify bacteria using traits
that are unique to bacteria, like cell walls and minerals they contain. The science section on “How Stuff Works” does a beautiful job of describing details of the sophisticated mechanisms antibiotics use to fight off bad
bacteria.
Antibiotic agents have been used to treat infectious
diseases for the last 70 years throughout the world. They have greatly reduced
illness and death, which is part of the reason we will most likely live twice
as long as our great-great grandparents. However, because we have successfully
used them for so long and so widely across the globe, infectious organisms are
learning to fight back against antimicrobial agents.
This is an increasing problem for society as antibiotic
resistant microbes can cause infected people to have longer and more expensive
hospital visits. They even increase our likeliness of dying from common
infections like the flu, which is usually the basis of zombie apocalypse
stories.
Why are we responsible for microbial resistance to drugs?
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Bacteria and other microbes have been exposed to the
substances that fight them for so long, they have learned ways to fight back,
like the tuberculosis bacteria in the picture above. Bacteria have several
methods to prevent antibiotics from doing their jobs. They can prevent the drug
from getting to the bacteria by adapting their membranes (like their protective
shells) so that the antibiotic can’t get through. Another way is by disguising
their structure so that the antibiotic can’t see them, like wearing a costume
to trick it. And in the most dramatic sense, bacteria have evolved to destroy
antibiotic by producing enzymes (for more explanation of enzymes, see my post on GMOs) that can chew up and
destroy the antibiotic. More details on how bacteria can mutate to be resistant
to antibiotics can be found here.
When we use antibiotics and other antimicrobial substances like
hand sanitizer and Lysol incorrectly, microbes begin to figure out ways to
survive. Similarly to how humans evolve, when microbes are not fully destroyed
they evolve resistances to our drugs. In other words, what doesn’t kill them
makes them stronger. Many of us do not follow our doctor’s prescription
directions, or doctors prescribe the wrong drug or dosage. People who
obsessively use antibacterial cleaners may actually be getting sick more often
for this reason.
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One example that many of us may be guilty of is stopping our
antibiotics too soon. Antibiotics should be taken until they are gone, even if
symptoms disappear before that. Lingering bacteria may remain in our system
that are not causing symptoms are the ones that will evolve to develop a mutation
and spread without causing new symptoms.
Another common mistake that people make is taking medicine
when they don’t need it. For example, getting antibiotics to treat something
they cannot kill, like a virus. Antibiotics are ineffective against viruses,
yet they are often prescribed. Taking antibiotics when you do not have a
bacterial infection will kill good and bacteria, as they cannot distinguish
between the two. Antibiotics kill the bad bacteria, but also kills the good
bacteria that help us function, like the flora that lines our intestines to
help us digest food.
What are the consequences of antimicrobial resistance?
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The WHO’s latest report has warned that antibiotic resistant
bacteria have emerged in every part of the world. The report outlines the
tracking, or “surveillance,” of the spread of resistance using a variety of
ways to survey the population. As more microbes become resistant to the drugs
that we have historically used to treat them, a wider spectrum of diseases will
occur and be problematic for future health care expenditures.
Health care costs will have a dramatic negative effect on the
economy. As the population spends more money on healthcare, individually or
universally, they have less to spend on savings and employers have less to
spend on income and employing more workers. As a result, the WHO has estimated
that there will be an increase in national investment, spending, and healthcare
delivery that will result in a reduced GDP by 1.4-1.6%. This amounts to to $20
billion in direct costs, and $35 billion in indirect costs.
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What can we do to stop the problem?
You can help reverse the dangerous path the world is on for
antimicrobial resistance. The WHO recommends that you only use antibiotics when
prescribed, and not to use any that are left from a previous prescription or
from another person. Finish your entire prescription when it is given to you,
even when your symptoms have completely gone away. And never, ever share you
prescription with someone else.
The WHO also recommends that health workers need to do a
better job of prevention control. They need to be more careful about only prescribing
antibiotics when they are truly needed, and to ensure that the correct ones are
used. Policymakers need to strengthen resistance tracking by increasing
laboratory capacity, which requires more investment in research. They should
also do a better job regulating and promoting the appropriate use of
prescription medicines.
Everyone together, across the world, can help foster
innovation for research and development of new vaccines, diagnostic tests, and
infection treatment options. In order to help mitigate the problem that is
rapidly threatening an apocalyptic type of ending, we will have to work
together to properly use antimicrobial agents responsibly, and to stop the
problem from getting worse. So, go do your part, spread the word, and enjoy
your good health!
Thanks for reading, and cheers to your brain!
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