Every day millions of doctors have to deal with people with diseases caused by one or more bacteria. However, it is increasingly difficult for them to eradicate them from the body due to the resistance they present, a fact that undoubtedly already worries the scientific and medical community, but that should worry everyone.
According to the World Health Organization ?WHO?, in the year 2050 there will be more deaths related to superbugs than by cancer, and these will be the main cause of death on the planet.
This study was revealed in 2017, three years before the COVID-19 pandemic, caused by the SARS-CoV-2 virus, and at that time scientists had no idea that this disease was going to drive excessive and incorrect consumption of antibiotics.
The bacteria Helicobacter pylori, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae and Salmonella spp are some of the microorganisms that in recent times have shown higher levels of resistance to various generations of antibiotics and that put the health of the population at risk. .
A list that, unfortunately, is growing more and more and today makes antimicrobial resistance a public health problem, qualified in 2020 by the WHO within the list of "urgent health problems of a global dimension".
The causes, says the WHO, are due to “a myriad of factors that have combined to create a terrifying cocktail, such as the unregulated prescription and use of antibiotics, the lack of access to quality medicines at affordable prices; the lack of clean water and sanitation services, and infection prevention and control.”
However, although the situation is more critical in marginalized and poor regions, with health crises, lack of water, and inadequate habits and hygiene, worrying levels of resistance to some bacterial infections have been found in both low- and middle-income countries. and tall; in men and women, regardless of age, race or social status, so it is a global problem.
An example of this is that a study led by experts from the WHO-supported Global Antimicrobial Resistance Surveillance System -GLASS- revealed the widespread presence of antibiotic resistance in samples of 500,000 people from 22 countries, in whom bacterial infections were suspected, with a wide variation from 0 to 82 percent in at least one of the most commonly used antibiotics.
Another study, by the Organization for Economic Cooperation and Development?OECD?, speaks of "a disturbing phenomenon of expansion, which could cost 3.5 billion dollars a year to the economies of its member countries."
The list of priority pathogens for the WHO included the degree of lethality of the infections they cause; whether or not the treatment requires prolonged hospitalization; how often they show resistance to existing antibiotics; the ease with which they are transmitted between animals, from animals to people and between people; whether or not the infections they cause can be prevented ?for example, through good hygiene and vaccination?; how many therapeutic options remain; and whether new antibiotics are being researched and developed to treat the infections they cause.
Included on the critical priority list are multi-resistant bacteria that are especially dangerous in hospitals, long-term care homes, and among patients who need to be cared for with invasive devices such as ventilators and intravenous catheters.
At the high and medium priority levels, bacteria whose drug resistance is on the rise and which are related, in many cases, to diseases acquired in the community, such as gonorrhea or Salmonella food poisoning, are included.
But what are superbugs and how do they manage to resist antibiotics?
Superbugs are strains of bacteria that have become resistant to known antibiotics, often including the most modern ones, and these try to survive against external aggressions and have an added advantage because they have a high facility to mutate as well as to breed.
Under the right conditions hundreds of millions can appear in a few hours. This allows their DNA mutations to be relatively fast and, in the case in which these modifications prove their usefulness and survive, this mutation can be refined more and more.
Superbugs occur due to the abuse of antibiotics, since when used too much or incorrectly, the bacteria that have caused the disease in question are overexposed and produce mutations in an attempt to survive.
This is known as “genetic capitalism”, a resistant bacterium has an evolutionary advantage, so it not only tends to stay, but it is also more likely to continue acquiring resistance mechanisms.
To this is added that, no matter how modern or sophisticated antibiotics are, bacteria will continue to perfect their mutations and, the more they are abused, the more bacteria will evolve to resist them. Problem that is no longer possible to reverse.
The WHO established three groups of multi-resistant bacteria, based on their priority.
- Priority 1 or critical, where all are resistant to carbapenems, the so-called broad-spectrum antibiotics, are Acinetobacter baumannii, Pseudomonas aeruginosa, some enterobacteria such as Klebsiella pneumoniae, Escherichia coli and several species of the genera Serratia and Proteus.
In the case of Klebsiellas, cases have already been found in which there is no longer any effective antibiotic.
- Priority 2 or high. At this level are Enterococcus faecium, which is resistant to vancomycin; Staphylococcus aureus to methicillin and vancomycin; Helicobacter pylori that is immune to clarithromycin; Campylobacter spp and Salmonella, both resistant to fluoroquinolones; and Neisseria gonorrhoeae with resistance to cephalosporins and fluoroquinolones.
- Priority 3 or medium. They include Streptococcus pneumoniae, which are no longer sensitive to penicillin; Haemophilus influenzae, resistant to ampicillin; and Shigella spp. immune to fluoroquinolones.
Since the problem cannot be reversed, one can slow down the problem by avoiding self-medication and allowing antibiotics to be prescribed by a doctor. In addition, it is necessary to avoid consuming them for diseases that have a viral origin, such as the flu.
To this, it is necessary to understand that the antibiotic treatment must be completed and not abandoned as soon as the symptoms disappear, since, if it is stopped before, it is possible that the bacterial infection will not be completely eliminated, making it go away adapting to the antibiotic and becoming resistant to it.
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