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Antimicrobial resistance occurs when previously successful treatments to combat microorganisms — including bacteria, viruses and some kinds of parasites — become ineffective.
When it happens, the resultant problems can quickly spread to large segments of the population as researchers race to come up with new interventions.
The results of a new study could shed some light on which areas of the world have the most substantial issues with antimicrobial resistance. It took a global look at the types of antimicrobial-resistant bacteria in healthy people. Here’s what was found.
Petri dish. Image credit: Drew Hays | Free image via Unsplash
Scrutinizing Sewage
To move forward with this study, the researchers turned their attention to metagenomics, which involves taking genetic material directly from genetic samples. In this case, the samples came from household sewage. After examining it for the presence of antimicrobial-resistant bacteria, the researchers concluded that it was possible to categorize areas of the world based on levels of resistance.
The study results showed that, in general, North America, Western Europe, Australia and New Zealand have the lowest levels of antimicrobial-resistant bacteria, and Asia, Africa and South America are at the other end of the spectrum — showing higher levels of that type of bacteria.
The research team also looked at the diversity of the resistance genes instead of merely the presence of the bacteria. They concluded that people from India, Vietnam and Brazil showed the most variation in resistance genes, while New Zealand and Australia had the lowest such diversity.
Overuse of Antimicrobial Drugs Is Only Part of the Problem
When discussing the antimicrobial resistance issue, people often point out that combating it requires physicians to be more careful about prescribing drugs like antibiotics when they won’t do anything to help a patient feel better. Indeed, research not related to this study confirms that over-prescribing antibiotics remains a major concern that contributes to antimicrobial resistance.
However, as the researchers for this project studied the sewage, they came across another connection, which made them realize that unnecessary use of antimicrobial medications is only partially to blame. They found that the majority of variables linked to high antimicrobial resistance relate to sanitary conditions and the general health of the population in the respective countries.
Professor Frank Aarestrup of the National Food Institute said the research supports that it would be “a very effective strategy” to make a dedicated effort to improve sanitation in the countries with the highest antimicrobial resistance levels.
The full text of the published study goes into detail about how the scientists conducted their research and the scope of the project. Specifically relevant to the latter matter is that this investigation involved 79 sample locations in seven geographical regions for a total representation of 74 cities in 60 countries. Some of the work relied on World Bank data sets that showed development stages and health statuses for the countries examined in the research.
Mapping Resistance Levels
The World Bank data also enabled the researchers to make a color-coded world map to predict levels of antimicrobial resistance in more than 250 countries. Various national initiatives are ongoing to reduce the antimicrobial resistance problem.
For example, in the United States, the Joint Commission is a nonprofit organization that issues voluntary accreditations for health care organizations. In 2017, it launched a medication management program to promote antimicrobial stewardship. That’s undoubtedly a helpful strategy for targeting antimicrobial resistance.
One of the outstanding things about the global map is that it may become a step toward a worldwide surveillance system that allows health officials to track the occurrence and progression of the microorganisms that cause disease, as well as antimicrobial resistance levels, and then exchange real-time information.
How Could This Research Improve Patient Care?
Knowing the antimicrobial resistance level in a patient’s country of origin could guide how that person gets treated. As a start, that information gives health care providers an idea of the potential effectiveness of a treatment. And, if a person has a highly contagious disease that may respond poorly or not at all to antimicrobial drugs, caregivers may deem it necessary to put the individual under strict quarantine as a preventative measure.
Additionally, other progress is emerging to test for antimicrobial resistance. Researchers designed a test that can tell if bacteria contains resistant genes that hinder the effectiveness of two common antibiotics, and the U.S. Food and Drug Administration (FDA) recently classified a product that detects 13 resistance genes in a patient’s blood sample in three to five hours as a breakthrough device.
Reusing the Metagenomics Data
Researchers are using the information from the sewage data to check for other microorganisms associated with diseases.
The raw metagenomics data is different from some other health data because it’s reusable, so both the findings of this study and the data itself could have far-reaching future effects.
Written by Kayla Matthews, Productivity Bytes