What is Antibiotic resistance? & Mechanisms behind antibiotic resistance.

Author: Hemalatha C H

What is Antibiotic resistance?

The detection of antibiotics is the main turning point in the healthcare field. An antibiotic is a medicine used to either kill or reduce the growth of bacteria. Antibiotic resistance is the ability of bacteria to inactivate the ability of macrolides to kill the bacteria. Antibiotic resistance is not developed by our body; it is developed by bacteria. Antibiotic resistance is the biggest challenge in the health care field. Antibiotic resistance is the protective action taken by the bacteria to protect themselves from the antibiotic. Because of this ability of the bacteria, it is very difficult to treat the bacterial infection, and it will keep human health in danger. Antibiotic resistance is a danger because it reduces the treatment options for bacterial infections.

Mechanisms behind antibiotic resistance:

• Bacteria can alter the target site of the antibiotic; the alteration is caused by a genetic mutation, a change in protein structure, or alternative pathways. Because of this, the antibiotic is unable to bind to the target site, so it cant show its action.
• Some bacteria have the ability to alter the permeability capacity of the bacterial cell wall, so it makes the antibiotic difficult to enter the cell. So it will reduce the concentration of the antibiotic inside the cell.
• Some bacteria have the ability to increase the action of the efflux pump, so the protein that is responsible for this will increase the ejection of the antibiotic from the cell.
• Some bacteria have the ability to produce specific enzymes that are responsible for inactivating antibiotic activity. Example: Some bacteria produce ß-lactamase enzymes that have the ability to inactivate the ß-lactate antibiotics [cephalosporin, penicillins, and monobactams].
• Antibiotic resistance can also be raised by genetic mutation, which is a very complex process. This mutation may be a result of natural selection, biological mutation, or acquiring the resistance gene from other bacteria through horizontal gene transfer like conjugation, transformation, or transduction.

Causes of antibiotic resistance:

• Inappropriate use and misuse of the antibiotics: It is like not completing the course of antibiotics, stopping in the middle, or sometimes consuming the antibiotic, which will not cure that specific infection. Sometimes, when consuming antibiotics for viral infections, antibiotics are specific for the bacterial infection that is also specific for the specific bacteria. Antibiotics will not cure the viral infection; they are used to cure the bacterial infection. This way of consuming antibiotics causes the development of antibiotic resistance.
• Agriculture factor: Using fertilisers and chemicals while growing food crops and then consuming those foods can cause antibiotic-resistant bacteria to transfer to the human body. Sometimes food crops exposed to contaminated water will also cause the transfer of resistant bacteria to the body.
• Hospital use: Sometimes physicians prescribe high doses of antibiotics to treat serious infections; this can also contribute to the spread of antibiotic-resistant bacteria.

Approaches to combat antibiotic resistance:

• Maintaining Cleanliness: Practicing hygiene to protect ourselves from infection can reduce the use of antibiotics. If there is more bacterial infection, the usage of antibiotics will increase, increasing the chance of bacterial infection. Mainly, hand hygiene will reduce the chance of getting a bacterial infection.
• Avoid unnecessary usage of antibiotics. Antibiotics are useful to treat bacterial infections, not viral infections. But sometimes the symptoms of a viral infection are similar to those of a bacterial infection. To avoid this, improved diagnostic practice can be helpful. This will help to distinguish between bacterial and viral infections.
• Executing Antibiotic Stewardship Programs: This program will give guidance and training to healthcare professionals regarding the best antibiotic choice, dose, duration, and route of administration.
• Supporting vaccination: vaccination reduces the use of antibiotics by preventing the occurrence of bacterial infections.
• Discovery of new antibiotics: manufacturing new antibiotics will improve treatment options for bacterial infections.

Alternative therapies:

• Phage therapy,which has the ability to target and kill specific bacteria, It works by infecting the bacteria and replicating inside them.
• Probiotics: Probiotics are live microorganisms that can maintain or improve the stability of good bacteria in our body. Probiotics have various health benefits that improve our digestion, boost our immune system, and reduce the chance of bacterial infection.
• CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-based Therapies: Gene editing has been transformed by the technology known as Clustered Regularly Interspaced Short Palindromic Repeats, or CRISPR. Antibiotic-resistant genes in bacteria can be targeted and removed using CRISPR-based therapeutics, which may result in the restoration of antibiotic sensitivity.
•  Essential Oils: Traditionally, infections have been treated with essential oils that contain antibacterial qualities. Tea tree oil, oregano oil, lemon oil, eucalyptus oil, and thyme oil are a few examples. For respiratory illnesses, these oils can be breathed in or applied topically.
• Nanoparticles: By precisely delivering antimicrobial drugs to bacterial cells, nanoparticles can boost their effectiveness and minimize their negative effects. Example: silver ions. Immunotherapy: Immunotherapeutic methods entail boosting the immune system’s capacity to identify and get rid of bacterial infections. This could involve creating vaccinations against germs resistant to antibiotics or using immunomodulatory treatments to strengthen the immune system of the patient.
• Combination therapies: Combining different antimicrobial agents increases effectiveness and lowers the risk of resistance development. Examples of these combinations include antibiotics plus adjuvants or other alternative therapies. In order to tackle resistant diseases, it may be more effective to use numerous medications in synergistic combinations.
• Inhibition of Quorum Sensing: Quorum sensing is a communication mechanism in bacteria that controls pathogenicity and the production of biofilms. One possible tactic to treat infections resistant to antibiotics is to inhibit quorum sensing pathways, which can interfere with bacterial colonization and pathogenicity.
• Hyperthermia: By causing direct bactericidal effects, increasing antibiotic action, upsetting bacterial biofilms, inducing immunological responses, and lowering antibiotic-induced side effects, hyperthermia offers a viable alternative therapy for the fight against antibiotic resistance.

Risk of antibiotic resistance:

• Treatment Ineffectiveness: As a result of antibiotic resistance, bacterial infections cannot be effectively treated with antibiotics, which results in treatment failure and chronic sickness.
• Increased Morbidity and Mortality: Compared to infections caused by susceptible bacteria, infections produced by antibiotic-resistant bacteria are linked to greater rates of morbidity and mortality.
• Fewer treatment Options: As a result of the growing antibiotic resistance, there are fewer and often no effective antibiotics available to treat bacterial infections, leaving patients with few or no options for therapy.
• Spread of Resistance: Due to reasons like abuse and misuse of antibiotics, insufficient infection control measures, and globalization, antibiotic resistance can spread quickly within and between communities, healthcare settings, and geographic regions.
• Stress on Healthcare Systems: Antibiotic resistance puts a heavy burden on healthcare systems, resulting in higher medical expenses, longer hospital stays, and a larger demand on available resources.

Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Streptococcus pneumonia (S. pneumoniae), Klebsiella pneumoniae (K. pneumoniae), Acinetobacter baumannii (A. baumannii), Pseudomonas aeruginosa (P. aeruginosa), Carbapenem-resistant Enterobacteriaceae (CRE), are the deadliest bacteria which caused most death from antibiotic resistant infection.

These bacteria are just a few examples, and there are many other macrolide-resistant bacteria that pose significant danger to people health. Additionally, if there is appearance of new strain of resistant bacteria it complicates the situation.

Conclusion:

In summary, the worldwide health community faces a serious threat from antibiotic resistance, which calls for an immediate response and broad approaches to lessen its effects. Antibiotic resistance mechanisms refer to the ways in which bacteria have evolved to resist the effects of antibiotics. These strategies include changes in drug targets, decreased drug permeability, and the production of enzymes that render medicines inactive. Antibiotic-induced bacterial survival and proliferation are made possible by these adaptive modifications, which raise treatment failure rates and morbidity and mortality.

There are several strategies for addressing antibiotic resistance. These include funding the development of novel antibiotics and alternative therapies, improving infection prevention and control measures in healthcare settings, encouraging international cooperation and surveillance efforts to track and stop the spread of resistant bacteria, and encouraging the responsible use of antibiotics through antibiotic stewardship programs.

But despite these initiatives, there are still a lot of problems associated with antibiotic resistance. The urgent need for persistent action is highlighted by the limited effectiveness of antibiotics, rising morbidity and death linked to resistant diseases, a lack of treatment alternatives, the burden on healthcare systems, the introduction of infections that are incurable, and impaired public health activities.

In conclusion, the public, legislators, researchers, and healthcare professionals must all work together to implement a multifaceted and well-coordinated approach to address antibiotic resistance. By implementing comprehensive strategies to avoid antibiotic resistance, we can ensure that antibiotics remain effective for the benefit of current and future generations and that progress in modern medicine and healthcare will continue.

References

• How Antimicrobial Resistance Happens https://www.cdc.gov/drugresistance/about/how-resistance-happens.html
• What is antibiotic resistance? https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/antibiotic-resistance.html
• what is antibiotic resistances https://www.nfid.org/antibiotic-resistance/
• The Antibiotic Resistance Crisis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378521/
• Antibiotic resistance https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/antibiotic-resistance
• Antibiotic resistance in environment https://www.nature.com/articles/s41579-021-00649-x