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RESISTANCE
CURRENT SCENARIO AND
CHALLANGES
Dr A K Praharaj
M.D, Ph.D
Professor, Microbiology
KIMS
RESISTANCE WAS FORESEEN EARLY
U. K
France
USA Korea
Japan
Thailand
Taiwan
Mexico
Colombia Singapore
Source: WHO
MECHANISM OF AMR
Genetic mutation
Production of antibiotic destroying enzymes
Efflux pump mechanism
Cell wall remodelling
Constitutional
Why is antimicrobial resistance a global concern?
New resistance mechanisms are emerging and spreading globally,
threatening our ability to treat common infectious diseases, resulting
in prolonged illness, disability, and death.
Without effective antimicrobials for prevention and treatment of
infections, medical procedures such as organ transplantation, cancer
chemotherapy, diabetes management and major surgery (for example,
GI surgery or hip replacements) become very high risk.
Antimicrobial resistance increases the cost of health care with
lengthier stays in hospitals and more intensive care required.
Antimicrobial resistance is putting the gains of the Millennium
Development Goals at risk and endangers achievement of the
Sustainable Development Goals.
Introduction of antibiotics in clinical practice and emergence of antimicrobial resistance.
P. falciparum:
Chloroquine resistance in 81/92 countries
WHO’s first release of surveillance data on antibiotic resistance
reveals high levels of resistance to a number of serious bacterial
infections in both high- and low-income countries.
WHO’s new Global Antimicrobial Surveillance System (GLASS)
reveals widespread occurrence of antibiotic resistance among
500 000 people with suspected bacterial infections across 22
countries.
The most commonly reported resistant bacteria
were Escherichia coli, Klebsiella pneumoniae, Staphylococcus
aureus, and Streptococcus pneumoniae, followed
by Salmonella spp.
WHAT ACCELERATES THE EMERGENCE AND SPREAD OF ANTIMICROBIAL
RESISTANCE?
Antimicrobial resistance occurs naturally over time, usually through
genetic changes.
Misuse and overuse of antimicrobials in people and animals accelerating
this process.
Antibiotics used in viral infection, growth promotion in animals and in
fishery
Antimicrobial resistant-microbes are found in people, animals, food, and
the environment (in water, soil and air).
They can spread between people and animals, including from food of
animal origin, and from person to person.
Poor infection control, inadequate sanitary conditions and inappropriate
food-handling
Using Antibiotics for Growth Promotion
When animals are given antibiotics for growth promotion or
increased feed efficiency, bacteria are exposed to low doses
of these drugs over a long period of time. This inappropriate
antibiotic use and can lead to the development of resistant
bacteria.
As of 2017, medically important drugs–those that are
important to human health–are no longer allowed to be used
for growth promotion or feed efficiency in the U.S.
Import and spread of extended-spectrum β-lactamaseproducing Enterobacteriaceae by international travellers
(COMBAT study): a prospective, multicentre cohort study
Global action