Question

Explain how bacterial resistance to antibiotics occurs? hiw can this be prevented?

Answer 1

Antibiotic resistance happens when micro organisms develop the ability to defeat the drugs designed to kill them. That means the germs are not killed and continue to grow.

Antibiotics kill germs that cause infections. But antibiotic-resistant germs find ways to survive. Antibiotics also kill good bacteria that protect the body from infection.Antibiotic-resistant germs can multiply. Some resistant germs can also give their resistance directly to other germs.Once antibiotic resistance emerges, it can spread into new settings and between countries.

Germ Defense Strategies

Antibiotics fightmicro organisms (bacteria and fungi). But germs fight back and find new ways to survive. Their defense strategies are called resistance mechanisms. Bacteria develop resistance mechanisms by using instructions provided by their DNA. Often, resistance genes are found within plasmids, small pieces of DNA that carry genetic instructions from one germ to another. This means that some bacteria can share their DNA and make other germs become resistant.

Examples of Defense Strategies for Germs

Germs can use defense strategies to resist the effects of antibiotics. Here are a few examples.

Resistance Mechanisms (Defense Strategies)

Restrict access of the antibiotic Germs restrict access by changing the entryways or limiting the number of entryways.

Example: Gram-negative bacteria have an outer layer (membrane) that protects them from their environment. These bacteria can use this membrane to selectively keep antibiotic drugs from entering.

Get rid of the antibiotic Germs get rid of antibiotics using pumps in their cell walls to remove antibiotic drugs that enter the cell.

Example: Some Pseudomonas aeruginosa bacteria can produce pumps to get rid of several different important antibiotic drugs, including fluoroquinolones, beta-lactams, chloramphenicol, and trimethoprim.

Change or destroy the antibiotic Germs change or destroy the antibiotics with enzymes, proteins that break down the drug.

Example: Klebsiella pneumoniae bacteria produce enzymes called carbapenemases, which break down carbapenem drugs and most other beta-lactam drugs

Bypass the effects of the antibiotic Germs develop new cell processes that avoid using the antibiotic’s target.

Example: Some Staphylococcus aureus bacteria can bypass the drug effects of trimethoprim

Change the targets for the antibiotic Many antibiotic drugs are designed to single out and destroy specific parts (or targets) of a bacterium. Germs change the antibiotic’s target so the drug can no longer fit and do its job.

Example: Escherichia coli bacteria with the mcr-1 gene can add a compound to the outside of the cell wall so that the drug colistin cannot latch onto it.

Prevention and control

Antibiotic resistance is accelerated by the misuse and overuse of antibiotics, as well as poor infection prevention and control. Steps can be taken at all levels of society to reduce the impact and limit the spread of resistance.

Individuals

To prevent and control the spread of antibiotic resistance, individuals can:

• Only use antibiotics when prescribed by a certified health professional.
• Never demand antibiotics if your health worker says you don’t need them.
• Always follow your health worker’s advice when using antibiotics.
• Never share or use leftover antibiotics.
• Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.
• Prepare food hygienically, following the WHO Five Keys to Safer Food (keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, use safe water and raw materials) and choose foods that have been produced without the use of antibiotics for growth promotion or disease prevention in healthy animals.

Policy makers

To prevent and control the spread of antibiotic resistance, policy makers can:

• Ensure a robust national action plan to tackle antibiotic resistance is in place.
• Improve surveillance of antibiotic-resistant infections.
• Strengthen policies, programmes, and implementation of infection prevention and control measures.
• Regulate and promote the appropriate use and disposal of quality medicines.
• Make information available on the impact of antibiotic resistance.

Health professionals

To prevent and control the spread of antibiotic resistance, health professionals can:

• Prevent infections by ensuring your hands, instruments, and environment are clean.
• Only prescribe and dispense antibiotics when they are needed, according to current guidelines.
• Report antibiotic-resistant infections to surveillance teams.
• Talk to your patients about how to take antibiotics correctly, antibiotic resistance and the dangers of misuse.
• Talk to your patients about preventing infections (for example, vaccination, hand washing, safer sex, and covering nose and mouth when sneezing).

Healthcare industry

To prevent and control the spread of antibiotic resistance, the health industry can:

• Invest in research and development of new antibiotics, vaccines, diagnostics and other tools.

Agriculture sector

To prevent and control the spread of antibiotic resistance, the agriculture sector can:

• Only give antibiotics to animals under veterinary supervision.
• Not use antibiotics for growth promotion or to prevent diseases in healthy animals.
• Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available.
• Promote and apply good practices at all steps of production and processing of foods from animal and plant sources.
• Improve biosecurity on farms and prevent infections through improved hygiene and animal welfare.

Recent developments

While there are some new antibiotics in development, none of them are expected to be effective against the most dangerous forms of antibiotic-resistant bacteria.

Given the ease and frequency with which people now travel, antibiotic resistance is a global problem, requiring efforts from all nations and many sectors.