Introduction
The World Health Organization considers considers antibiotic resistance to be one of the most pressing threats to global health. Antibiotic resistance (AR) is the process in which bacteria develop the ability to evade the drugs designed to kill them. While resistance is a natural phenomenon, the widespread overuse of antibiotics in medicine and agriculture has exacerbated the issue. Although modern medicine has made advancements to address AR, bacteria can act quickly and have evolved to evade our best defenses. Resistant strainsof bacteria spread globally and can pass their resistance to other microbes. Without swift intervention, it is predicted that by 2050, AR could cause 10 million deaths globally each year.
Implications of Antibiotic Resistance
AR has profound implications for children, the elderly, immunocompromised individuals, and BIPOC populations. The incidence of many AR infections are disproportionately higher among these groups primarily due to weakened or underdeveloped immune systems and social determinants of health. Manifestations of these diseases can include ear and sinus infections, pneumonia, and infections of the bloodstream.
In 2021 alone, nearly 11 million people contracted the bacterial infection tuberculosis (TB), resulting in 1.6 million deaths globally. Multidrug-resistant TB was discovered in 1956, and today accounts for 200,000 TB deaths annually. Immunocompromised individuals, like those living with HIV, are at the highest risk of developing multidrug resistant tuberculosis. TB spreads through aerosolized respiratory droplets that are released when an infected individual speaks, coughs, or sings. The disease is especially contagious in cramped living quarters.
Another common antibiotic resistant infection comes from Methicillin-resistant S. aureus (MRSA), a hospital-acquired infection that in 2017 resulted in an estimated 120,000 cases and 12,000 deaths in the U.S.. MRSA is exceptionally difficult to treat, with symptoms ranging from skin infections to sepsis, a potentially fatal complication of an untreated infection. Approximately 5% of patients in U.S. hospitals are silent carriers of this disease, with MRSA bacteria living on their skin or in their noses. It is easily spread through skin-to-skin contact. Without action, MRSA will continue to threaten vulnerable populations.
Federal Actions to Address Antibiotic Resistance
The previous Congress introduced the STAAR Act and Pasteur Act, both of which would bring federal agencies together to collaborate on ways to reduce the risk of AR. At this time, only the Pasteur Act has been reintroduced. Additionally, the National Action Plan for Combating Antibiotic-Resistant Bacteria is a collaborative, interagency effort providing an innovative framework to address AR.
The action plan outlines the need for improved usage of antibiotics across industries, most notably, the food and agricultural industry and the healthcare industry, as they contribute greatly to AR. Providers are encouraged to adopt responsible and evidence-based antibiotic prescribing practices to reduce the overall number of antibiotics prescribed annually. Similarly, the action plan calls to limit the amount of medically- important antibiotics fed to livestock, as well as invest in preventative therapy research to reduce the use of antibiotics in agriculture altogether. While the action plan sets forth strategic guidelines, these efforts can be costly and time-intensive. As such, it will take a concerted effort from dedicated industry professionals to adequately reduce the rates of preventable deaths attributable to AR.