Over 12,000 deaths each year caused by infections by resistant bacteria. 430,000 people hospitalized who contracted a hospital-acquired infection between 2022 and 2023. Antibiotics administered to 44.7% of patients in the ward, compared to the European average of 33.7%.
These are the numbers that emerged from an AIFA (Italian Medicines Agency) dossier that confirm theItaly as “black shirt” in Europe in the phenomenon of antimicrobial resistance. And reiterated by the National Congress of SITA – Italian Society of Anti-infective Therapy.
Tailored prescriptionsand only by the doctor, are the basis of the right behavior to follow. And it is important to follow them well instructions from the doctorwithout suspending treatments when the symptoms disappear. But it’s not enough. The environment must also be followed. This is according to a study conducted in South-East Asia which focuses attention on animals, in a “One Health” logic.
Asia, spotlight on animals
We are talking about distant realities, but the theme must be kept in mind. As reported by research that analyzed the situation in South-East Asia, published in the International Journal of Food Science and Technology, it is necessary particular attention to food also in terms of antimicrobial resistance.
The research was conducted by Rajaraman Eri and Charmaine Lloyd of RMIT University in Australia together with Thai expert Pushpanathan Sundram. According to experts, theSoutheast Asia it can be considered as a potential epicenter of the potential transmission of antibiotic resistance from animals to humans. The numbers are impressive. According to recent data from the Food and Agriculture Organization, in the area there are over 2.9 billion chickens, 258 million ducks, 7 million cattle, 15.4 million buffaloes, 77.5 million pigs, 13.7 million sheep and 30.6 million goats. Farm experts say the presence of antibiotics in food, soil, water runoff and animal waste can contribute to the development of this resistance.
So excessive and improper use of antimicrobial drugsparticularly for the promotion of growth in healthy animals, can be linked to a increase in resistance rate. Since resistant bacteria in animals can be transferred to humans through the food chain or by direct contact, this transmission route highlights the connection between human and animal health, underlining the need to address antimicrobial resistance in farm animals. Also because sometimes it happens that through this route germs take on the genetic characteristics that make them unassailable.
A now dated research by experts at Ohio University has demonstrated, for example, the existence of a “horizontal transfer” of resistance genes, which pass through a commensal microorganism for the human body, and transmit their characteristics to pathogenic microbes. But it is only one of the secrets through which bacteria “take” those genetic stigmata that protect them from drugs and that they can also arrive from foreign organisms to ours.
How much antibiotic resistance affects humans
The phenomenon of antimicrobial resistance (AMR) and hospital-associated infections (HAI) represent a heavy burden on health systems and societywith significant annual costs due to healthcare costs. Artificial intelligence (AI), in continuous and rapid evolution, could contribute in a concrete way to the discovery of potential new drugs to deal with the phenomenon of AMR, becoming a tool to support the clinician in the decision-making process of choosing the therapy.
Antimicrobial resistance is a crucial issue, a true global emergency which concerns everyone: hospital doctors, clinicians and citizens. The data is alarming: globally, the estimates indicate 5 million deaths per yeara figure destined to grow to almost 40 million by 2050 if adequate measures are not adopted.
“Antimicrobial resistance risks becoming the leading cause of death in the world – comments Matteo Bassetti, President of SITA, Clinical Director of Infectious Diseases at the San Martino IRCCS Polyclinic Hospital in Genoa and Professor of Infectious Diseases at the University of Genoa. The problem is that resistant bacteria, the so-called “superbugs”, are increasingly difficult to treat with existing antibiotics. In the face of these new threats, there is an urgent need to “superantibiotics”. However, research in this field has suffered a setback, making greater investment in development and innovation essential. We also need a more effective approach to reimbursement of new antibioticsespecially in Italy, and a more appropriate management of their use, which does not just mean reducing their use, but using them in a more targeted and conscious way”.
What can be done
According to recent studies, antibiotic resistance would be among the ten threats to health and the global economy. And we need to act. According to what the documents of the Global AMR R&D Hub and the WHO have recently reported, attention must be paid not only to the well-being of the population but also to the economic one. The document reports that antibiotic resistance is associated with 4.95 million deaths worldwide in 2019, of which over 1.2 million direct) and that, according to estimates, it could cause 39 million deaths by 2050.
Economy chapter: if the methods of approaching the problem do not change, the treatment of resistant bacterial infections alone will entail a global economic burden of $412 billion in healthcare costs And $443 billion in lost productivity every year until 2035. Infection prevention remains a priority objective, but the other essential weapon to combat resistant bacterial infections is the availability of antibiotics. However, the report highlights how much remains to be done. The report indicates how there are only 32 new antibiotics in clinical developmentand most of them are derived from existing classes. Only 12 innovative drugs are in development, and only 4 against at least one particularly feared pathogen according to WHO indications. In short: the road is long.
Strategies for the future
Let’s just talk on the medical front. While waiting for news, it is certainly essential to use the drugs we have available well. Unfortunately we are still witnessing a misuse of antibioticswhich perhaps are used to treat viral pathologies when they are completely useless against viruses. But these errors are even more worrying if we consider that exposing bacteria to meaningless antibiotic treatments increases the risk of them developing resistance mechanisms. So it’s necessary be careful and always keep in mind that the more antibiotics are used, the greater the possibility of bacterial resistance arising. Not only that: it is necessary to evaluate the use of antibiotics in combination with great care because it can give rise to multiple resistances which can make the use of drugs from different families useless in the future.
