The mention of antimicrobial resistance strikes fear in some and demands response from many. In this first of a four-part series, we will look at the issue; in Part 2 we will try to answer the question of what is antimicrobial resistance; in Part 3 we will ask who is to blame for it; and in Part 4 we will look at some possibilities to move forward on this issue.
The importance of the topic to animal health professionals and agricultural producers was evident by the attendance of 170 people at a November conference on the topic of antibiotic resistance sponsored by the National Institute of Animal Agriculture in Columbus, OH.
I attended the conference on behalf of Michigan State University Extension. While at the conference, it seemed that we didn’t find out all the answers to the perplexing issue, but began to better understand the questions. Such is the complexity of this issue.
The issue is the resistance of infectious bacteria to antibiotics that are supposed to kill or control them. Thus, they can become uncontrolled. This represents a potential threat to the health of animals, humans and even plants. Indeed, the length of time of medical treatment and the costs associated with that increase greatly for people infected with resistant bacteria. There is also increased risk of death. It is therefore important for all involved to ask questions about the causes and spread of antibiotic resistance.
Antibiotic resistance would be less of a problem if we were developing new tools and new antibiotics to fight infection at a pace that exceeded the progress of resistance. However, the pace of antibiotic development has been slowed in recent years with more research data being required to increase safety and decrease unanticipated consequences. The slower approval process has meant that very few antibiotics have been approved either for human use but especially for animal medicine.
The rise of methicillin-resistant Staphylococcus aureus, also known as MRSA, was a challenge to the medical practice that brought the topic of resistance to the consciousness of many. Staph. aureus is a pathogen of people as well as being an important pathogen in animal agriculture. Its treatment in animals raised the question of whether that is responsible for the development of resistance in humans.
The fact is that there are growing levels of resistance, not only to this pathogenic bacteria, but to others as well. This has implications for control of infectious diseases in humans, animals and plants where antibiotics have been used to treat, prevent, and control diseases. So, has the successful use of antibiotics created a situation where successful treatment will be more difficult?
It was clear from the start of the conference that this is a much more complex issue than that. Dr. Lonnie King, Dean of The Ohio State University College of Veterinary Medicine, stated that “antimicrobial resistance will occur without antibiotic use, with judicious antibiotic use, but especially with misuse or overuse.”
According to Dr. King, there is consensus of a problem, but not consensus on solutions or even accountability. The solutions to the problem of resistance will not be simple, and will need to be a collaborative effort involving all segments of the medical community and society in general. It requires what has been termed a “One-Health” approach – the collaborative effort of multiple disciplines to attain optimal health for humans, animals and the environment.
It also will require a global approach as the issue is not confined to this country, and what happens in another country can be quickly transmitted throughout the world.
The first take-home message from the conference was that antimicrobial resistance is not a problem that will be solved by finger-pointing and blame-shifting but rather through the collaborative work of many to seek honest answers and try solutions.