By Femi Olawuyi
Antimicrobial resistance (AMR) against antibiotics for bacteria is a serious global health issue, and medical science has not been able to solve the problem. Like one of my literary pieces on AIDS/HIV expresses, “fast we continue to move but AIDS, much faster” (AIDS – A Living Threat). The same thing can be said of bacteria. We tend to fight them with the tough approach, but their own genetic act of defense is much tougher; so it seems medical science is losing the battle. Consequently, public health suffers globally, and research scientists seem to be exhausted of innovative therapeutic solutions against AMR.
The recent global health report of the World Health Organization (WHO) confirmed that we are indeed losing the battle against the AMR problem and global health is obviously threatened. Hence, the WHO called for enhancing solutions for AMR through the AMR surveillance campaign. Although I support the AMR surveillance campaign, there are two approaches to combatting this issue that should be profoundly included: preventive and genetic engineering-based therapeutics.
The preventive approach should focus on antibiotic misuse and overuse, which allows bacteria to get used to the broad spectrum of antibiotics to enhance their antigenic resistance mechanism against antibiotics. My recommendation on prevention of antibiotics misuse and overuse in my previous AAPS Blog post coincides with some recommendations of tackling antibiotics resistance in the April 30 WHO global report on antibiotic resistance. Experienced physicians and healthcare professionals should prescribe the antibiotics for patients; patients with drug abuse problems should be vetted through medical history data collection; patients should be educated to complete their full prescription even when symptoms disappear during the course of medication; patients should be educated to not share their antibiotics prescriptions; aggressive broad spectrum antibiotics prescriptions by physicians, pharmacists, and other qualified health professionals should be discouraged; a global campaign against over-the-counter antibiotics sales should be enhanced; and meat from animals treated with antibiotics should be well-labelled.
Therapeutic approaches should also include gene-focused treatment of bacterial infections. Bacteria brilliantly resist our antibiotic agents through tough genetic manipulation. The increase in antimicrobial resistance can be ascribed to differences in immunogenic response of patients in different countries. One of the contributing factors to this can be further connected to the different strains of bacteria of the same group. The instance cited by WHO in its AMR campaign report on the global disparity of resistance of gram-negative bacteria, Klebsiella pneumoniae (bacteria causing a hospital-acquired infection known as nosocomial infection) against the beta-lactum class, broad-spectrum antibiotics carbapenems is a good example. The WHO record asserted that resistance of the nosocomial infection-causing bacteria against carbapenems was observed in 50 percent of the infected people.
I agree with the perspective of the Washington Post’s editorial board that there is the possibility of exchange of resistance genes (putative genes) among bacteria through human transmission. So we need both preventive approach and genetically-engineered antibiotics to fight against the antibiotic resistant genes. Genetic engineering-based therapeutic techniques such as RNA Interference (RNAi) can be also explored to tackle the antimicrobial resistance of infectious bacteria.