Antibiotic resistance is a global threat to the treatment of bacterial infectious diseases.
Antimicrobial resistance is the broader term for resistance in different types of microorganisms, and encompasses resistance to antibacterial, antiviral, antiparasitic and antifungal drugs.
When microorganisms become resistant to most antimicrobials, they are often referred to as superbugs.
This is a major concern because a resistant infection may kill, can spread to others, and imposes huge costs to individuals and society. Medical procedures such as surgery could become extremely difficult, or even impossible, due to antimicrobial resistance. Common infections may become untreatable which could lead to death.
Antibiotics are antimicrobial drugs that kill or stop the growth of bacteria to cure infections in people, animals and sometimes plants.
Not all antibiotics are active against all types of bacteria. There are more than 15 types of antibiotics. They may be broad spectrum, which means they can kill more than one type of bacteria, or narrow spectrum, meaning they will only kill one type of bacteria.
Causes of antimicrobial resistance
Some causes of antimicrobial resistance include:
- Taking antibiotics for the wrong reason. The common cold and the flu are caused by viruses. Antibiotics are not effective against viruses.
- Not finishing a course of treatment which can lead to resistance to certain medicines.
- Some microorganisms which cause infection, survive exposure to the medicine (antimicrobial) that would normally kill them or stop their growth.
- Poor infection prevention and control practice, such not washing your hands.
Diseases and conditions caused by antimicrobial resistance
Bacteria resistant to antimicrobials are found in the community and healthcare settings, and can cause infections such as urinary tract infections, pneumonia, bloodstream infections, skin infections and diarrhoea, to name a few.
Patients in hospital may be at risk of getting other infections that can be unrelated to their admission. Some of the more common antibiotic-resistant infections include:
- Methicillin Resistant Staphylococcus aureus (MRSA), commonly known as the hospital superbug
- Extended Spectrum Beta-Lactamase (ESBL)
- Vancomycin Resistant Enterococci (VRE)
These infections can cause a range of complications for people whilst in hospital.
The situation worldwide, and in New Zealand
Globally, the situation is getting worse, with the emergence of new bacterial strains that are resistant to several antibiotics at the same time; over time, these resistant strains may become resistant to all existing antibiotics.
Recent data from the 2014 World Health Organization (WHO) Global Antimicrobial Resistance report indicate that New Zealand has comparatively low rates of antimicrobial resistance, particularly when compared to countries in neighbouring regions such as South-East Asia. However, New Zealand should not become complacent, as there has been a rise in antibiotic resistance to some types of infections and increasing consumption of antibiotics.
What we’re doing in New Zealand
It's essential to use antibiotics responsibly. By doing this, we can help stop resistant bacteria developing and ensure antibiotics are available for future generations. There are a range of New Zealand initiatives to address aspects of AMR including, education, surveillance, hand hygiene, restrictions on prescriptions and use of antimicrobials.
Some of the work is funded by the Ministry, and some work is done in collaboration with other groups, such as district health boards, health professionals and other groups.
Some of the groups involved in antimicrobial resistance work include:
- Best Practice Advocacy Centre New Zealand (bpac nz)
- Health Quality and Safety Commission
- Healthcare Associated Infections Governance Group
- Ministry for Primary Industries
- The New Zealand Microbiology Network
What you can do to minimise antimicrobial resistance
- Follow you doctor’s advice when taking antibiotics. Always finish the prescribed course of antibiotics on time.
- Do not take antibiotics that have been prescribed for someone else.
- Wash your hands regularly, particularly if you have a cough or cold or sneezing. Wash your hands before touching your face, objects, or other people.
- Where possible, prevent infection through vaccination.
What healthcare professionals can do to minimise antimicrobial resistance
- Prescribe antibiotics only when necessary, according to evidence based guidelines. When possible, prescribe a narrow spectrum antibiotic, not broad spectrum.
- Advise patients on the importance of taking their treatment correctly.
- Explain to patients how to relieve symptoms of cold and flu without antibiotics.
- Explain to patients how to prevent the spread of infection and the importance of vaccination.
- Adhere to good infection prevention and control practices.