Introduction
There is a rapid emergence of drug-resistant pathogens across the world. This phenomenon has endangered the efficacy of drugs such as antibiotics which have helped transform modern medicine and saved countless lives. Many years after the first use of antipathogens, the pathogens are increasingly becoming a threat again. The cause for this phenomenon has been attributed to the misuse of these drugs as well as the lack of innovation from the pharmaceutical industry because of diminishing economic incentives in a challenging regulatory environment. The Centers for Disease and Controls (CDC) has raised the alarm about the issue and classified some pathogens as posing serious, urgent threats that could place severe strain on health systems.
Literature Review
Antimicrobials are drugs that are administered to treat diseases caused by pathogens. These drugs include antivirals, antibiotics, antifungals, and anti-parasites. They prevent and cure infections in plants, animals, and humans. On the other hand, Antimicrobial Resistance (AMR) occurs when viruses, bacteria, fungi, and parasites adapt over time and stop responding to medicines making treatment harder and elevating the disease spreading risks, severe illnesses, and death. Because of this, antimicrobials become ineffective while diseases become increasingly challenging to treat.
What Speeds AMR
AMR is a process that occurs naturally over time as a result of genetic changes. These drug-resistant pathogens can be found in people, food, animals, and the environment (air, soil, and water). The pathogens can spread from animals to people, people to people, and even from food to people. The major causes of AMR are the overuse and misuse of antimicrobials; poor access to clean water, hygiene, and sanitation for people and animals; inadequate disease control and prevention facilities; lack of access to affordable and quality diagnostics, medicines, and vaccines; and finally lack of knowledge and awareness and insufficient enforcement of regulatory legislation.
Drug-resistant Bacteria
Resistance to common bacterial infections such as sepsis, urinary tract infections (UTIs), sexually transmitted infections (STDs), and some types of diarrhea have been reported across the world. This indicates a shortage of effective antibiotics. According to WHO’s article Antimicrobial resistance, (n.d.), resistance against ciprofloxacin, a drug that treats UTIs varied between 8.4% and 92.9% for E. coli and between 4.1% and 79.4% for intestinal bacteria Klebsiella pneumoniae. Treatment of K. pneumoniae with last resort carbapenem antibiotics has become widespread across the world (Aslam, et al., 2018). These bacteria are a major contributor to hospital-acquired infections (HAIs) such as bloodstream infections and pneumonia among newborns and ICU patients. Carbapenem antibiotics do not work for an estimated 50% of patients due to resistance in some countries.
There is also a rise in E. coli resistance against fluoroquinolone antibiotics used to treat UTIs. It has been reported in many parts of the world that this treatment no longer works for approximately 50% of patients (Aslam, et al., 2018). The last-resort treatment against life-threatening infections from pathogens such as E. coli and Klebsiella is colistin. Incidentally, there are also reports of bacteria resistant to colistin, meaning that there are now infections without known effective ways of treating. Antibiotic-resistant Mycobacterium tuberculosis trains are curtailing progress in the fight against the TB epidemic. According to the article Antimicrobial resistance (n.d.), there were approximately half a million cases of TB resistant to rifampicin across the globe. This underscores the seriousness of the scourge that continues to ravage the world.
Drug resistance in Viruses
Antiviral drug resistance continues to raise concerns, especially for immunocompromised persons. In these populations, persistent viral replication and prolonged exposure to drugs cause resistance. Resistance has been reported for many classes of viruses, including resistance to antiretroviral drugs (ARVs). In particular, ARVs could become inactive as drug-resistant HIV (HIVDR) emerges (Irwin et al., 2016). People can be infected with this HIV strain, and those under ARV medication can also acquire the HIVDR. Among adults entering therapy for the first time, resistance levels of pre-treatment HIVDR(PDR) against non-nucleoside reverse transcriptase inhibitors (NNRTIs) were more than 10% in most of the countries monitored in Asia, Africa, and Latin America. According to Irwin et al. (2016), more than 50% of infants diagnosed with HIV in Sub-Saharan Africa carried a virus resistant to NNRTI.
Drug Resistance in Fungi
There is an increase in drug-resistant fungi, which has complicated the already difficult treatment process of fungal infections. Many fungal infections pose serious treatment challenges, especially for people with underlying medical conditions such as HIV infection (Wiederhold, 2017). Drug resistance has been reported in one of the most common fungal infections, Candida Auris. The phenomenon has been observed against such antifungals as fluconazole, voriconazole, amphotericin, and caspofungin (Wiederhold, 2017). This is making it more difficult to treat fungal infections causing prolonged hospital stays, thus making treatment more expensive.
Discussion
Treatment against pathogens has come a long way; the discovery of penicillin was a turning point in the treatment of bacterial infections. From the literature review, it was reported that there is a growing concern against the rise of antibiotic-resistant bacteria. Some of the bacteria strains that have been discovered to be resistant to antibiotics include Klebsiella pneumoniae and E. coli. These are dangerous pathogens that threaten the health of millions. One of the most worrying facts about drug-resistant bacteria is that they arise from the natural process of natural selection. Nevertheless, there is a part that human beings can play to slow down the process, such as the proper use of antibiotics.
Bacterial infections are typically easier to treat than their tinier counterparts, viruses. Drug-resistant viruses continue to complicate the already difficult process of treating viruses. Of particular concern is the emergence of ARV-resistant HIV strains. As it is, HIV is a scourge that has ravaged the world and caused deaths in the millions and billions of dollars lost in the fight. The emergence of drug-resistant HIV strain is a serious problem since it is exacerbating the already dire situation in the poorest of regions.
Fungal infections are one of the most difficult pathogens to treat. The literature review discovered that there is an emergence of drug-resistant strains of fungal parasites. Candida Auris is an example of these pathogens, where resistance to a wide array of antifungal drugs has been reported. An intersection was reported where it becomes more difficult to treat fungal infections for people with chronic conditions from other pathogens such as HIV. A multisectoral approach is therefore required to defeat this existential menace to humankind.
Conclusion
This paper focused on the emerging threat of drug-resistant pathogens such as viruses, bacteria, and fungi. Interestingly, antimicrobial resistance was observed to be a natural process that results from natural selection. AMR is an existential crisis for mankind that seeks to curtail the progress made in medicine. Drug-resistant pathogens cause economic strain on the already burdened healthcare systems; it becomes a double tragedy by debilitating workers who would otherwise be produced in the economy and could even lead to death and reduced overall life expectancy. The seriousness of the problem calls for a multisectoral national and global approach to solve the issue.
References
Aslam, B., Wang, W., Arshad, M. I., Khurshid, M., Muzammil, S., Rasool, M. H., Nisar, M. A., Alvi, R. F., Aslam, M. A., Qamar, M. U., Salamat, M., & Baloch, Z. (2018). Antibiotic resistance: a rundown of a global crisis. Infection and Drug Resistance, 11, 1645–1658. Web.
Antimicrobial resistance. (n.d.). Web.
Irwin, K. K., Renzette, N., Kowalik, T. F., & Jensen, J. D. (2016). Antiviral drug resistance as an adaptive process. Virus Evolution, 2(1), vew014. Web.
Wiederhold, N. P. (2017). Antifungal resistance: current trends and future strategies to combat. Infection and Drug Resistance, 10, 249–259. Web.