Confronting antimicrobial resistance of animal origin

This article was exclusively written for The European Sting by Ms. Angeliki Moutafi, Mr. Dimitrios Samaras, Mr. Ioannis Saperas and Mr. Lampros Fountoulis, all medical students from Greece. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Could you imagine a world in which there is no treatment option against the vast majority of infectious diseases? Could you imagine physicians and health professionals being frightened and unable to help you due to the mass restriction of offered treatment options? That situation is not an ominous and distant future but a dreadful reality. According to the World Health Organization (WHO) antimicrobial resistance is the ability of microorganisms such as bacteria, viruses, fungi and parasites to undergo change when they are exposed to antimicrobial agents, causing them to become resistant to these medications. Antimicrobial resistance occurs naturally but the improvident consumption and misuse of antimicrobial preparations is accelerating that process. Some examples of inappropriate use which leads to the transformation of microorganisms into more resistant forms are: the misuse of antibiotics against viral infections like flu (antibiotics are useless against viruses), the consumption of antibiotics without prior consultation with a physician and the over-prescription. In the last decade a strong link between drugs for veterinary reasons and antimicrobial resistance has been identified .Therefore, the cooperation between veterinarians and medical doctors is more urgent than never before. Zoonoses are infections that are transmissible between animals and humans. They can be acquired through different routes of transmission: For instance, by eating contaminated food and drinking contaminated water and by coming into contact with infected animals, animal wastes and environment. Farmers and food industries use antimicrobials in animals with the primary goal to prevent and control zoonoses, but also to promote growth. However the increased consumption of animal product has led to catachresis of antimicrobials, with future usage in pig and poultry production predicted to double.. But how does the animals’ antibiotic resistance affects humanity? It can render current treatment ineffective and increase the disease severity. It can also affect productivity and cause economic losses. Last but not least, it can pose a serious threat to human health. The WHO recommends several guidelines to encounter this upcoming crisis.

• A reduction in general use of all classes of antibiotics in food-producing animals can reduce the prevalence of resistance.
• Complete restriction of use of antimicrobials in food-producing animals for growth promotion.
• Complete restriction of use of antibiotics in food-producing animals given prophylactically for infectious diseases that have not yet been clinically diagnosed.
• Critically important antimicrobials should not be used for control of the dissemination of a clinically diagnosed infectious disease within food-producing animals.
• Highest priority critically important antimicrobials for human medicine should not be used for treatment of food-producing animals with a clinically diagnosed infectious disease.

All previous measures are based on several reviews on multiple studies. Highest priority antibiotics are: quinolones, 3rd and higher generation cephalosporins, macrolides and ketolides, glycopeptides and polymyxins. All in all, we are entering into an era where more and more common infections become challenging to treat. Yet, the situation is not irreversible and it is within our responsibility and strength to act in a corporate way. Interprofessional collaboration between the public health, animal health and environment sectors is more critical than ever, so that we manage to encounter this threat, before it becomes widespread. References https://www.who.int/en/news-room/detail/07-11-2017-stop-using-antibiotics-in-healthy-animals-to-prevent-the-spread-of-antibiotic-resistance https://www.who.int/foodsafety/areas_work/antimicrobial-resistance/cia_guidelines/en/ http://www.fao.org/antimicrobial-resistance/key-sectors/animal-production/en/ https://www.cdc.gov/features/antibiotic-resistance-food/index.html https://ifmsa.org/wp-content/uploads/2018/03/Antimicrobial-Resistance-.pdf About the authors Angeliki Moutafi is from Greece and she is a fifth year medical student. Reproductive health has always been one of her areas of interest, with the advocacy for reproductive rights being her greatest passion. One of her beliefs is that all the health care professionals should collaborate towards the common goal of creating a safe, trustworthy environment, where all people are able to embrace their reproductive rights and receive adequate health care, regardless their sex, nationality, religion and sexual orientation. Dimitrios Samaras comes from a beautiful small town called Kastoria. He exhibits passion to learn and research, really likes all aspects of medicine with cardiology being the most appealing. He prefers to spend his time reading classical books, playing chess and working out. Before studying medicine, he was helping with the business of his family. It has always been his dream to work as a doctor and be able to help people that are in need. His name is Ioannis Serepas, he is from Greece and he is a fifth year medical student. Public health problems along with human rights issues are some of his biggest concerns. He is a firm believer that the link between humanitarian values and health is inevitable and we are obligated to work in order to shape a better world for ourselves and our posterity . A world in which the values of solidarity, peace and democracy will be the epicenter of our everyday life. His name is Lampros Dimitrios Fountoulis, a fifth year medical student who comes from athens the capital of greece.His true ambition is to become an emergency doctor and to work in third world countries for a part of his life.In the past he has participated in different medical emergency,first aid and trauma care programs.He prefers spending his spare time by working out,reading books and hanging around with friends.the values that determine him are neutrality, impartiality, non-discrimination, personal commitment, and respect for human dignity.