Reasons for Resistance
There is no one cause that can be solely held responsible for the spread of resistance. The reasons are diverse and require multi-sectoral and multi-stakeholder cooperation on a global level.
Antibiotic Use
Humans, Animals, Agriculture
Among the primary cause of bacterial resistance is the use of antibiotics – both where such use is warranted and especially where such use is unwarranted and inappropriate. The disbursement of antibiotics without prescriptions, particularly in low and middle-income countries where the controls are weak, have significantly contributed to the rise of resistance in such regions. Although the pattern of resistance to the first-line antibiotics is higher in the former group of countries, the numbers are far from promising in the developed world. This problem cannot be reduced to a geographical region, not in the present era of globalization where the world is becoming truly borderless.
In addition to humans, the sub therapeutic use of antibiotics in animals is another major reason for the spread of resistance. Recent reports of resistance to the last report antibiotic – Colistin in China has come as a shock to the world and is reportedly a result of Colistin abuse in animals.
When such animal waste, coupled with untreated hospital discharges and improper waste disposal from industries, is used in the form of fertilizers or water for irrigation and contain drug-resistant bacteria. This could lead to the transfer of such bacteria to the food crops and eventually into the human digestive system. This is a vicious cycle that needs to be abridged requiring a multi-dimensional strategical approach and political commitment.
Infection Control
Hospitals are the breeding grounds for drug-resistant bacteria and the transfer of such resistance from one bacteria to another is facilitated in hospitals with poor infection control. The human body is more susceptible to infections during illness as immune systems are compromised. Thus, it is crucial to ensure that hospitals implement disinfection guidelines to improve hospital ecology.
Lack of Surveillance Mechanisms
Mechanisms to capture data on resistant microorganisms crucial to follow their spread among people and geographical regions. Lack of such surveillance mechanisms makes it incredibly difficult to track drug-resistant infection outbreaks and consequently prevents policymakers to take measures to control the spread of such infections.
Lack of Awareness
Antibiotic misuse due to lack of awareness is not uncommon. Improper dosage, incomplete course of antibiotic treatment are all factors that contribute towards drug resistance. Common misconceptions like using antibiotics for the treatment of infections like cold, flu, malaria, etc. that are caused by viruses, parasites or any microorganism other than bacteria account for a major proportion of antibiotic abuse and lead to ABR.
Poor Vaccination and Hygiene
Poor vaccination leads to increased chances of infections, which leads to increased antibiotic usage. Similarly, improper personal and community hygiene leads to easier bacterial transfer, spreading resistance. Simple steps like cleaning hands properly and regularly can go a long way in combating the spread of resistance.
