The threat of antimicrobial resistance
“Antimicrobial resistance is the ability of microorganisms, such as bacteria, to become increasingly resistant to an antimicrobial to which they were previously susceptible. AMR is a consequence of natural selection and genetic mutation. Such mutation is then passed on conferring resistance. This natural selection process is exacerbated by human factors such as inappropriate use of antimicrobials in human and veterinary medicine, poor hygiene conditions and practices in healthcare settings or in the food chain facilitating the transmission of resistant microorganisms. Over time, this makes antimicrobials less effective and ultimately useless.” (EFSA 2019).
Antimicrobial Resistance (AMR) is such a threat to human beings that it was described as a “ticking time bomb” (Walsh 2013) and a “global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals” (United Nations 2019). Every year, in the US, about 3 million people get an antibiotic resistant infectious disease and about 35.000 die (CDC 2019). In the EU, about 33 000 people die every year because of AMR (EU Commission 2020). Worldwide, the total number of deaths per year due to AMR is estimated to be 700.000 (O’Neill 2016) while the economic burden in the EU alone is about 1.5 billion euros/year (EU Commission 2020). The AMR trend is complex; between 2005 and 2015, the first signs that actions to counter AMR were having positive effects appeared in some High-Income Countries (HICs). In Switzerland, the United Kingdom, Japan, Belgium, Germany, Iceland, and Canada, resistance across eight antibiotic-bacterium combinations fell by an average of 2.5 percentage points (OECD 2016). However, for other HICs during the same period, the index showed a significant increase. In Italy and the Slovak Republic there was an increase of 10.6% (OECD 2016). At the same time, AMR was growing quickly in Low- and Middle-Income Countries (LMICs). 40–60% of recorded bacterial infections in the Russian Federation, India, and Brazil are from antimicrobial- resistant pathogens, compared to an average of 17% in countries belonging to Organization for Economic Co-operation and Development (OECD 2016). If proper steps are not taken, the number of people who will die annually because of AMR by 2050 will reach 10 million (more than deaths due to cancer) and economic losses will reach one trillion USD annually by 2030 (World Bank 2017).
To what extent is AMR due to the use and misuse of antimicrobials in agriculture?The growth of AMR is due both to the use of antibiotics in humans and on animal farms. While it is easy to understand the impact of therapeutic antibiotic treatment on the people, the pathways for passing antimicrobial-resistant pathogens from animals to humans are more complex. Resistant bacteria arise both directly in the treated animals and in the environment, especially in freshwater sources, polluted both by farm and human wastes. Antibiotic-resistant genes then move to humans in multiple ways: by direct contact between farmers and animals, through contaminated soil and water, and, even if to a lesser extent, through contaminated foodstuffs.Data about the amount of Anti Microbial Resistant Bacteria (AMRB) in meat, milk, and aquaculture products are still not regularly produced even in some EU countries. Evidence ex
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