Antimicrobial resistance (AMR) and Antibacterial Resistance (ABR)


Antimicrobial resistance (AMR) is a global health and development threat that occurs when microbes (such as bacteria, viruses, fungi and parasites) evolve mechanisms that protect them from the effects of antimicrobials (drugs used to treat infections) . That means the germs are not killed and continue to grow, making infections harder to treat and increasing the risk of disease spread, severe illness and death .

Antibiotics are a type of antimicrobials that are used to treat bacterial infections. Antibacterial resistance (ABR) is a subset of AMR that refers to the resistance of bacteria to antibiotics . ABR is one of the most serious forms of AMR, as bacteria cause many common and life-threatening infections in humans and animals. ABR can also lead to the emergence and spread of multi-drug resistant (MDR) bacteria, also known as "superbugs", that are resistant to different types of antibiotics with different structures and modes of action .

AMR and ABR are driven by the misuse and overuse of antimicrobials in humans, animals and plants, as well as by the lack of access to quality antimicrobials, clean water and sanitation, and infection prevention and control measures . AMR and ABR pose a serious challenge to modern medicine, as they compromise the effectiveness of antimicrobials that are essential for treating infections, including during major surgery, cancer chemotherapy, organ transplantation and chronic diseases .

The World Health Organization (WHO) has declared that AMR is one of the top 10 global public health threats facing humanity . According to the WHO, at least 700 000 people die each year due to drug-resistant diseases, including 230 000 people who die from multidrug-resistant tuberculosis. More and more common diseases such as pneumonia, gonorrhoea, and salmonellosis are becoming harder to treat as the antibiotics used to treat them become less effective. Without urgent action, AMR could cause 10 million deaths each year by 2050 and damage the economy as much as the 2008-2009 global financial crisis .

In this article, we will explore the four mechanisms of AMR development, the difference between resistance to a particular class vs multi-drug resistance (MDR), the further classification of MDR into extensively drug-resistant (XDR) and pan drug-resistant (PDR), and the lists of priority pathogens issued by the WHO and the US Center for Disease Control and Prevention (CDC) to guide research, discovery and development of new antimicrobials. We will also discuss the possible solutions and actions that can be taken to prevent and control AMR and ABR at different levels.