What causes AMR?
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to antimicrobials, making infections harder to treat and increasing the risk of disease spread, severe illness and death.
Antimicrobials is a term that is used to refer to antibiotics, antivirals, antifungals and antiparasitics. Antimicrobials are medicines used to prevent and treat infections caused by microorganisms in humans, animals and plants. Bacteria can become resistant to antibiotics, viruses to antivirals, fungi to antifungals and parasites to antiparasitics.
The main cause of AMR in bacteria is antibiotic use. While antibiotics are essential to modern medicine, the more antibiotics Australians use, the faster resistant bacteria will develop. Because antibiotics in Australia are used to treat humans and animals, to reduce AMR we need to understand the interconnection between people, animals and our shared environment. This is called a 'One Health' approach.
A One Health approach is important because antibiotic resistant bacteria can potentially spread between and within sectors in a number of ways.
Antibiotic use by humans puts pressure on bacteria to become resistant. Resistant bacteria can spread between people via direct contact, coughing, sneezing and exposure to bodily fluids. Bacteria can also pass between companion animals, livestock or wildlife and to humans through direct contact.
Antibiotic use in animals also puts pressure on bacteria to become resistant. Resistant bacteria from food-producing animals can move through the food supply chain and be present in food consumed by humans. Resistant bacteria can move through the environment and contaminate food crops. Humans can transfer resistant bacteria from themselves to food during production or preparation.
Resistant bacteria present in animal waste, human waste and food waste can also contaminate the environment, including soil and water. Bacteria that are present in the environment can then spread back to animals, food and humans. This interconnectedness makes a One Health Approach essential to tackling the problem of AMR.
Why is AMR a problem?
AMR is a serious health threat to both humans and animals because it threatens to reduce the effective prevention and treatment of infections caused by bacteria, parasites, viruses and fungi.
The threat of antibiotic resistant bacteria is a major concern in the world today. Antibiotics are antimicrobial medicines. They work by killing bacteria, slowing their growth or stopping them from causing infection. Antibiotics help the body's natural immune system fight bacterial infections.
Since the 1940s, antibiotics have saved millions of lives and have contributed to the increased life expectancy today. They also made many lifesaving medical procedures safer including:
- organ transplantations
- chemotherapy
- caesarean sections
- surgeries.
AMR happens when disease causing bacteria become resistant to the antibiotics used to kill them. Taking antibiotics will destroy most of the bad bacteria, however, sometimes a few resistant bacteria can survive. These can then multiply and spread. Bacteria can develop resistance through mutation (random changes to DNA) or sharing of genetic material from one bacteria to another. As a result of AMR, antibiotics can become ineffective and as a result common diseases are becoming untreatable, and lifesaving medical procedures riskier to perform.
Misuse and overuse of antibiotics contribute to the emergence and spread of resistant bacteria. Bacteria are developing resistance to classes of antibiotics faster than new, more effective antibiotics can be produced. Most of the antibiotics used today were developed over 30 years ago and only a small number of new antibiotic classes have been approved in the last two decades. Some bacteria have become resistant to all classes of antibiotics that were effective against them and today there are no longer effective antibiotics to treat the infections they cause.
There are at least 700,000 deaths each year globally from antimicrobial resistant infections. This is projected to increase by 2050 to 10 million annually if no action is taken[1]. It is estimated that an average of 290 persons die each year in Australia due to infections with resistant bacteria[2]. By 2050 the estimated annual impact of AMR on the Australian economy could be between A$142 billion and A$283 billion[3].
More information
For more information on AMR, the Australian Government National Strategy, and what you can do to help reduce AMR please visit https://www.amr.gov.au
[1] https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf
[2] https://www.oecd.org/australia/Stemming-the-Superbug-Tide-in-Australia.pdf
[3] https://outbreakproject.com.au/2020/04/22/superbugs-to-trigger-our-next-global-financial-crisis/