HOT TOPIC: Antimicrobial Resistance

The pathogens that cause infectious diseases and the vectors that carry them are increasingly resistant to the drugs and insecticides used to control them.

Antimicrobial resistance (AMR) – the ability of bacteria, viruses, fungi and parasites to continue to grow even in the presence of medications that would normally kill them or inhibit their growth – is expanding. The inappropriate use of antimicrobials, including their overuse in agriculture, animals and humans; low-quality or fraudulent medicines; poor infection prevention and control; and inadequate disease surveillance, diminishes our arsenal of tools that treat and prevent infectious disease. Because AMR puts at great risk the advances made in reducing sickness and death caused by infectious diseases and because the issue cuts across human, environmental and animal health, it is the quintessential One Health issue.

But AMR is also a “One World” issue: increasing movements of people, livestock and agricultural produce; globalization of the food system; and travel and trade foster the spread of resistant genes. AMR has reached crisis proportions. 

  • The emergence of a plasmid-mediated resistance gene (mcr-1) to colistin identified in people and pigs in China rapidly spread to other parts of the world. (see ProMED archive number: 20151122.3810204 and others.)
  • In 2008, New Delhi metallo beta lactamase 1 (NDM-1), a transmissible genetic element encoding resistance genes against most known beta-lactam antibiotics, spread worldwide from its point of emergence in India (see ProMed archive number: 20100815.2812.)

Growing numbers of antibiotics have been rendered ineffective. We’ve seen that regardless of a nation’s commitment to address AMR, all are at risk of importing AMR organisms and genes that have emerged and spread from other parts of the world.

AMR requires global One Health solutions. Comprehensive action at international, regional and national levels involving human and veterinary medicine, agriculture, wildlife, environment, industry, government and consumer groups is urgently needed.

Solutions will not be the same in every country or every sector. We know that some use antibiotics too much, but some use them too little. Some misuse stems from antibiotics that are too readily available without diagnosis or prescription; in other places antibiotics and medical care are too expensive hampering proper treatment. Understanding patterns of use and incentives for changing these, and exploring alternative options, must guide efforts to combat AMR.

ISID is committed to the global action on AMR. We support these efforts through global surveillance; research to strengthen knowledge and understanding; outreach and education through IJID, ICID, IMED, ProMED and the Guide to Infection Control; and advocacy and awareness building through communication with our global membership of infectious disease professionals and the public. 

ISID is committed to supporting the WHO global action plan “to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.”

Resources

Related ISID programs and meeting materials, regional guidlines, and other relevant reading culled from around the world.