If we imagine the pre-antibiotic world where people die of tetanus, diphtheria, anthrax and many other deadly
bacterial diseases, we could not even imagine the pain of parents who lost
their children for smallpox and children who impaired their lives due to
polio. People succumb to cholera, botulism and fear of eating food, drinking
water, touching the soil. Even a cool breeze could have turned a tornado of
diseases. We have seen the films showing the dreadfulness of plague where most
of the human population fainted to death and migrations in all part of the
world. A bite of a flea could make you die from plague and bacteria. Ahh ….
Horrible scenes could come to your eye and make your eyes wet a bit if you just
close and go a look at a pre-antibiotic and pre-vaccination era of 18th and
19th centuries
and before that. And then, the time came, when people started saying during world
wars “Thanks to penicillin he will come back home after the war”.
If we put a small question of what
is the impact of all those periods reoccur now? One can wisely answer today the
advances in vaccination and medicines can be real tools to tackle all the
calamities, the medical sciences have developed to an extent where we could
even detect the entire human genome and these pathogens are just a speck to handle.
But if the people think these answers they are fully wrong. It’s just because
of the warning that these dreadful organisms giving us by evolving themselves
“Drug-Resistant”.
WHO warns Antimicrobial
resistance is not a new problem, but one that is becoming more dangerous;
urgent and consolidated efforts are needed to avoid regressing to the
pre-antibiotic era.
What is Drug Resistance?
Drug resistance is a condition in
which a drug or an antibiotic turns ineffective against the disease-causing
microbe. It is the condition where our immune system which acts as a drug the delivery system fails to recognize the particular strain of drug-resistant
microbe hence fails to induce the response on it and also it is a condition in
which a drug used to inhibit or kill or eradicate particular microbe fail to
act on it and hence the condition of the disease remains uncured and a potential threat to humans.
Drug resistance is due to various
reasons, but the main reason is the mutation in a particular protein on which a
drug or our immune system acts and there are various reasons for mutations in the microbe. Here a microbe either alters the substrate that is required by
antibiotic or immune system’s enzyme to acts or else microbe produces an enzyme
that would alter the structure of the drug itself. The organism that is
resistant to multiple drugs is called Multidrug-resistant (MDR) microbe and
these MDR’s are the major concern that is threatening to the human population.
Reasons for Mutations and drug resistance
Horizontal
gene transfer from one organism to others, which is a natural way of acquiring
drug resistance.
Use
of disinfectants, antiseptics, pesticides, insecticides kill normal flora which
are beneficial to humans, these flora fights with pathogens and protects humans.
When this Good microbe’s population decreases it leads to the evolvement of new
organisms.
The
overuse of antibacterial cleaning products in the home may be producing strains
of multi-antibiotic-resistant bacteria.
Improper
use of anti-microbial's that leads to the evolvement of no of drug resistants is one
of the major causes.
Weak
infection prevention and control practices lead to the increased transmission
of resistant microorganisms. This is particularly challenging in
resource-limited settings with poor health infrastructures and a shortage of
health-care staff. Inadequate laboratory capacity limits the ability to rapidly
detect resistant microorganisms for prompt treatment and control measures.
Mechanisms by which drug resistance occurs
Modification
of drugs
Alteration
of target site
Difference
in metabolic pathway
Reduction
in drug accumulation by decreased dug permeability or increased efflux of the drug.
Important Examples
Evolvement
of new malarial parasites
Methicillin
resistant Staphylococcus aureus
MDR
tuberculosis
Penicillin
and major antibiotic-resistant microbes
Aids
a potent cause
Note
about these examples: I will post separate articles on each of them in future
days.
Responsibilities on us
Avoid misuse of drugs in any sort mainly by discontinuing the entire course of
drug as by avoiding self- medication.
“Prevention
is better than cure” Prevention of disease by keeping personnel and
environmental hygiene.
Stop
forcing doctors to give antibiotics and vaccination until it is mandatory.
Assure
your drug quality before using.
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