Antimicrobial 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 health care 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 antimicrobials responsibly. By doing this, we can help stop resistant bacteria developing and ensure effective antimicrobials are available for future generations.
Combatting Antimicrobial Resistance (AMR) in New Zealand
The Ministry of Health contracts the Institute of Environmental Science and Research Limited (ESR) to undertake an extensive AMR surveillance programme and other activities related to combatting AMR, including establishing and providing support to the Healthcare Associated Infections Governance Group (HAIGG) and the New Zealand Microbiology Network.
There are also a range of other initiatives in New Zealand aimed at combatting AMR including, education, surveillance, hand hygiene, restrictions on prescriptions and the use of antimicrobials.
Development of a National AMR Strategic Action Plan
In May 2015, the World Health Organization (WHO) global action plan to tackle AMR was endorsed by the World Health Assembly. This plan outlines the following five strategic objectives to tackle AMR.
- Improve awareness and understanding of AMR
- Strengthen knowledge through surveillance and research
- Reduce the incidence of infection
- Optimize the use of antimicrobial agents
- Ensure sustainable investment in countering antimicrobial resistance
New Zealand has made a commitment to WHO to have a national AMR action plan in place by May 2017.
Work on the plan is underway and includes establishing an AMR Strategic Action Plan Development Group to progress a cross agency national strategic action plan that is adaptive and responsive with the aim of minimising the incidence of AMR across New Zealand. This group has stakeholder representation from across government agencies, and other relevant professional bodies and will feed back to governance structures within the Ministry of Health, the Ministry for Primary Industries and other agencies as required.
The first meeting for this Group will took place at the beginning of March 2016. The Minutes and Terms of Reference are available below.
- Minutes, AMR Strategic Action Plan Development Group, July 2016 (Word, 77 KB)
- Minutes, AMR Strategic Action Plan Development Group, July 2016 (PDF, 500 KB)
- Minutes, AMR Strategic Action Plan Development Group, March 2016 (Word, 105 KB)
- Minutes, AMR Strategic Action Plan Development Group, March 2016 (PDF, 487 KB)
- Terms of Reference, AMR Strategic Action Plan Development Group (Word, 31 KB)
- Terms of Reference, AMR Strategic Action Plan Development Group (PDF, 439 KB)
The AMRAPG met on the 7 September 2016 – minutes to be published end of September.
Several new reports have been released by The Institute of Environmental Science and Research (ESR) and the Ministry for Primary Industries (MPI).
- ESR: Antibiotic consumption in New Zealand 2006–2014
- ESR: Antimicrobial resistance in human isolates of Campylobacter jejuni, 2015 (PDF, 345 KB)
- MPI: The Emergence of Campylobacter jejuni ST 6964 in Poultry in New Zealand and its Associated Antimicrobial Resistance (PDF, 1.8 MB)
This page will be updated regularly as work on the Plan progresses.
What health care 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 antibiotic.
- 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.