Antimicrobial resistance is a major global issue that is only getting worse. Acquired resistance is defined by the emergence of coding genes for strategies of drug evasion from antimicrobial agents. The Entero-bacteriaceae family has been linked to this behavior. Antibiotics like beta-lactams and carbapenems, which are the most used types, are used to treat bacterial infections. From a clinical perspective, research on antibiotic resistance is very important because of the effects it has on human health. Furthermore, one of the rare instances of evolution that can be researched in real time is antibiotic resistance. Therefore, doctors, evolutionary biologists, and ecologists are interested in understanding the general processes involved in the acquisition of antibiotic resistance. Environmental microbes are the source of antibiotic resistance genes that are currently found in human diseases. Therefore, research on both natural and medical environments is necessary to fully comprehend the emergence of antibiotic resistance. Recent findings about the evolutionary processes underlying resistance suggest that viability costs, the founder effect, and ecological connectivity are significant barriers that control the spread of resistance from environmental bacteria to diseases.
Subgroups with a high prevalence of resistance
Travelers returning to nations with modern healthcare systems are frequently the first to the identify "new" antibiotic resistance problems, and screening and the laboratory testing are the strongly advised for people returning after receiving healthcare (Adler et al., 2011; Yong et al., 2009). From very low baselines in those countries, returning Dutch and Swedish international travelers were the reported to have 24% ESBL colo-nization rates. Asymptomatic military personnel sta-tioned in Afghanistan were reported to have 10-fold higher colonization rates of the E. coli that contained ESBL than those stationed in the US (Hasan et al., 2014; Musyok et al., 2019). Antibiotic resistance is also sometimes highly prevalent in the long-term inhabitants of the elderly care institutions, who are frequently exposed to medical care, antibiotics, and common cross-transmission of microorganisms. Hos-pital-linked infections with Staphylococcus aureus, the Staphylococcus epidermis, Stenotrophomonas malto-philia, Streptococcus pneumoniae, Acinetobacter bau-mannii, Burkholderia cepacia, Campylobacter jejuni, Citrobacter freundii, Clostridium difficile, Entero-bacter spp., Enterococcus faecium, Enterococcus fae-calis, E. coli, Haemophilus influenzae, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeru-ginosa, Salmonella spp., and Serratia spp., are the available antibiotic resistance data, in which antibiotic exposure and cross-transmission are expected to be increased (Davies & Davies, 2010; Musyok et al., 2019).
Antibiotic resistance in isolates from environmental and agricultural sources
Resistance is likely influenced by antimicrobials used in animal husbandry as well as trash and effluent from manufacturers and hospitals (Diwan et al., 2010). Human and animal waste contaminates the environ-ment, and in both resource-poor and resource-rich nations, highly resistant E. coli may be present in the drinking and environmental water supplies. Similar multi-resistant isolations to humans may be found in domestic pets. Antibiotic-resistant human infections are also frequently found in food and in animals that are part of the food chain (Schmiedel et al., 2014; Timofte et al., 2011). Animals in the wild are the frequently impacted, especially scavengers like sea-gulls, who are significant carriers of the antibiotic resistance in the infections known to affect humans (Iredell et al., 2016).
Bacterial resistance strategies against antibiotics
Antibiotic-resistant bacteria are a serious and the expanding global issue. Antibiotic-resistant bacteria have evolved a variety of defense mechanisms, making illness treatment difficult. These resistance mecha-nisms might be acquired (formed over time because of selective pressure from antibiotic use) or intrinsic (occurring naturally). A list of antibiotics and their modes of action are given in Table 2.
Table 2: Names of drugs and their resistance mechanisms (Davies & Davies, 2010; Morar & Wright, 2010).
Antibiotic management plans
Antibiotic stewardship programs, also known as anti-biotic management plans, are comprehensive initia-tives used in hospital settings to guarantee the prudent use of antibiotics. These strategies seek to minimize the emergence of antibiotic resistance, enhance patient outcomes, and maximize the use of antibiotics. Global antibiotic resistance control is a long-term endeavor requiring tenacity & cooperation from nations, institu-tions, healthcare systems, and the public. We can stop the development of antibiotic resistance and ensure that antibiotics remain effective for the upcoming generations by cooperating and putting these methods into practice. Here are some key strategies for the antibiotic resistance management:
Antibiotic stewardship
This entails using antibiotics sensibly and only pres-cribing them when essential. Medical practitioners should refrain from giving antibiotics for viral infec-tions and instead choose the appropriate drug, dosage, and course of therapy.
Public awareness and education
It is crucial to raise public awareness of the risks associated with antibiotic resistance. Its critical that people comprehend the significance of taking anti-biotics exactly as the directed, refraining from sharing medications, and not forcing physicians to prescribe drugs when none are necessary.
Surveillance and monitoring
Its important to regularly monitor patterns of antibiotic resistance. This information can direct public health initiatives and assist medical professionals in making well-informed judgments regarding which antibiotics to prescribe diseases.
Infection prevention and control
Appropriate controls for infections in healthcare envi-ronments can help stop the spread of microorganisms resistant to antibiotics. This covers precautions like hand washing, isolating patients who have infec-tions that are resistant, and following sanitation guidelines.
Research and development
To counteract the emergence of resistance, it is critical to develop novel antibiotics and complementary thera-pies. It is essential to the fund research into novel antibiotics and treatments.
Vaccination
Antibiotic use can be decreased using vaccines, which can help avoid numerous bacterial infections. In this sense, vaccinations against certain forms of meningitis and bacterial pneumonia, for example, have proven helpful.
One health approach
It is essential to understand how the health of people, animals, and the environment are interconnected. For instance, the use of antibiotics in agriculture may enco-urage the growth of resistant bacteria that may harm people. In a "One Health" strategy, the human and animal health sectors work together to manage anti-biotic resistance holistically.
Regulatory measures
Governments have the power to control the use of antibiotics in both agriculture and healthcare. One way to reduce resistance is to implement and enforce laws and regulations that limit the improper use of anti-biotics.
Development of fast diagnostic tests
Accurate antibiotic prescriptions can be made by the health-care professionals with the aid of enhanced diagnostic tests that can rapidly determine the kind of infection and the bacterium causing it.
International cooperation
Since antibiotic resistance is a worldwide issue, coope-ration between nations is the crucial. Nations can cooperate on research and policy development, as well as exchange information and best practices.
Alternative therapies
One viable way to the fight antibiotic resistance is to investigate and develop non-antibiotic medicines like phage therapy, antibodies, and other cutting-edge tech-niques.
Patient engagement
One way to stop the overuse of antibiotics is to encour-age patients to take an active role in their care. This entails talking about available treatment alternatives, posing inquiries, and realizing how crucial it is to adhere to recommended treatment plans.
Antibiotic resistance is a global health crisis that the develops when bacteria develop the ability to survive and multiply in the presence of the antibiotics. This resistance might make treating bacterial infections more difficult, which might lead to infections that are more serious and the require longer recovery times. Antibiotic resistance must be controlled if antibiotics are to be effective in the future as well as the present. To effectively control antibiotic resistance, a multidisc-ciplinary strategy involving the medical professionals, rese-archers, legislators, and the public is needed. To counter this growing threat to the public health, cooperation is essential.
We regret failing to properly credit the authors for numerous important works in the subject. Over the 200,000 publications have been made regarding resistance to antibiotics since the 1950s, so while our selection was selective, it was not meant to be all-inclusive. We would like to the extend our sincere gratitude to our family, our supervisor and the co-supervisor, for helping me to prepare the manuscript.
The authors declare no conflict of interest
Academic Editor
Md. Ekhlas Uddin Dipu, Department of Biochemistry and Molecular Biology Gono Bishwabidalay, Dhaka, Bangladesh.
PhD Researcher, Department of Microbiology, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh.
Asad MA, Katha ZS, Shorna SY, and Ayaz M. (2023). A review of antibiotic resistance: global reports, sources, incidents, resistance strategies, and control plans, Eur. J. Med. Health Sci., 5(6), 256-264. https://doi.org/10.34104/ejmhs.023.02560264