GS Paper - III

Ahead of the UN General Assembly High-Level Meeting on antimicrobial resistance, the World Health Organization recently published its first-ever guidance on antibiotic pollution from manufacturing. The emergence and spread of AMR (antimicrobial resistance) caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites…, the WHO said on 3 September 2024.

What is antimicrobial resistance (AMR)?

• AMR is a condition in which a pathogen acquires the ability to survive and cause infection even in the presence of an antimicrobial drug. AMR is the result of evolution of microbes in a situation where there is a misuse or overuse of antibiotics.
• Excessive use of antimicrobial drugs can lead to the creation of resistant or extremely resistant superbugs, which can circulate in hospitals, through drinking water, or sewers.
• Infections caused by these pathogens will not respond to commonly prescribed antibiotics.
• Growing antibiotic resistance would mean that simple infections would become difficult to treat — for example, doctors have reported patients requiring admission to hospital for the treatment of even urinary tract infections.
• Within hospitals, this is likely to lead to more complications and longer stays, making the treatment increasingly more expensive.

Why is AMR increasing?

• INDIVIDUALS: Many Indians have a tendency to pop an antibiotic for a fever, without even checking if the fever is caused by a bacterium.
• DOCTORS: Doctors must be educated to not use broad-spectrum antibiotics. These are antibiotics that work against a wide range of infections, but these are also the ones that are more likely to lead to resistance.
• DIAGNOSTICS: Another problem is empirical prescription of antibiotics, made by doctors based on what they think has likely caused the infection based on the symptoms. Instead, doctors should, wherever possible, insist on diagnostic tests that can help them prescribe specific antibiotics for the infection rather than broad-spectrum ones.
• PHARMA COMPANIES: The WHO’s guidelines on antibiotic pollution from manufacturing released provides guidance on wastewater and solid waste management for antibiotic manufacturing facilities.

What are the most common resistant pathogens in India?

• The three most common pathogens isolated in patient samples from tertiary care centres in the ICMR surveillance network are e. coli, which can cause gut infections; Klebsiella pneumoniae, which can cause pneumonia and urinary tract infections; and Acinetobacter baumannii, which is mainly associated with hospital acquired infections, the recent report said.
• E. coli isolates demonstrated a decrease in susceptibility to most antibiotics, with susceptibility to carbapenem reducing from 81.4% in 2017 to 62.7% in 2023.
• Klebsiella pneumoniae also showed reduced susceptibility, with the susceptibility to two different medicines from the carbapenem class reducing from 58.5% to 35.6% and 48% to 37.6% between 2017 and 2023.
• While no significant change was found in susceptibility for Acinetobacter baumannii, its resistance to carbapenems stood at 88% in 2023. Pathogens such as this are highly resistant to even strong antibiotics.