Antimicrobial Resistance: A Ticking Time Bomb?

Credit: M J Richardson

Credit: M J Richardson

Antimicrobial resistance has been referred to as one of the biggest health crises facing the world today. It has been estimated that more than 700,000 cases occur every year worldwide. As well as, predictions suggesting that without further prevention cases could increase dramatically over the next 30 years.

What is antimicrobial resistance?

According to the World Health Organisation, antimicrobial resistance (AMR) occurs when microorganisms including bacteria (e.g. urinary tract infections), viruses (e.g. HIV), fungi (e.g. Candida) and parasites (e.g. malaria) become modified in such a way that the medications used to tackle their infections are no longer effective.

Antimicrobial resistance is a broad term that includes all microbes from viruses to parasites. Antibiotic resistance, on the other hand only refers to bacteria change due to the administration of antibiotics to treat bacterial infections, whereby they become ineffective.

Microorganisms that develop a resistance to antimicrobials are referred to as “superbugs”. There are many health implications associated with the existence of superbugs. They have the potential to kill and spread rapidly which imposes huge costs to both individuals and society.

A degree of antimicrobial resistance will occur naturally, however, it seems to be exacerbated by the inappropriate use of medicines, for example treating viral infections such as the flu with antibiotics and the extensive application of antibiotics in farming.

But how many people has antimicrobial resistance already affected?  And what are the experts predicting will happen in the future?  

The complexes of this subject mean the number of cases of AMR  is difficult to assess. Firstly, it is important to consider the difference between AMR contributing to deaths as opposed to causing them. It is not the resistance to drugs alone that causes death; it just causes an infection to become harder or impossible to treat.

In the majority of situations, it is impossible to know if an individual has died as a result of a resistance because there are many factors that may have played a role. However, it is known that AMR causes mortality rates for infections to rise. For instance, individuals are 50% more likely to die from drug-resistant E.Coli compared to a strain of E.Coli that responds to antibiotics.

There is some conversely around the number of AMR cases within the UK. A number of professionals have disputed the government’s estimated figure of approx 5,000 related deaths a year.

Experts have claimed that NHS data confirms many more people have died with a drug resistant infection than previously anticipated. It is thought that it could be at least double the figure stated especially when you look into the rates of sepsis for example.

According to Dr Ron Daniels, chief executive of the UK Sepsis Trust, at least 12,000 people, a year in the UK are dying from drug-resistant sepsis (blood poisoning) alone.  On a global scale, evidence suggests that at least 700,000 deaths in 2014 were linked to infections caused by AMR. It is expected cases could reach 10 million/year by 2050.

It is vital that the importance of this potential epidemic is acknowledged. The effective surveillance of cases going forward is essential. A lack of information into the prevalence of AMR cases prevents necessary action to be taken, as the true scale of the threat is not yet recognised. This, in turn, could limit the funding that would be made available to the research of preventative methods.

The World Health Organisation has launched a campaign World Antibiotic Awareness Week which aims to increase awareness of this important issue and to encourage best practices among the public, health workers, farmers, food producers, veterinarians and policymakers to avoid the further emergence and spread of antibiotic resistance.

This year, World Antibiotic Awareness Week will be held from 13 to 19 November, for further information please click here.