Bacterial resistance: the significant worldwide problem

This article was exclusively written for The European Sting by Ms. Ketelly Bueno Koch, 21, fifth semester medical student at the University of Caxias do Sul, Brazil. She is 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 writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Throughout the process of knowledge and creation of the first antibiotics, the world’s population was thrilled to learn that it could cure itself of fatal bacterial diseases. From the discovery of the first antibiotic, Penicillin, in 1928 by physician Alexander Fleming, pathologies such as syphilis, gonorrhea and pneumonia could be cured, increasing the survival of the world population. However, with the advent of science and the study of microbiology, bacterial resistance was discovered, a process in which natural selection occurs, where the stronger genetically bacteria survive the antibiotic used, thus propagating and generating more bacteria of the same genotype. This problem affects a large part of the world’s population, constituting one of the biggest current public health problems. In Brazil, it is estimated that there are 23,000 annual deaths due to the problem. Thus, diseases that were previously cured with only one antibiotic no longer respond to treatment, leading to aggravation of pathologies that were easily eradicated. The World Health Organization’s list of the most resistant bacteria in the world before was seven bacteria in 2014, rising to 12 in 2017, showing an imminent threat to public health. However, it is of utmost importance to have knowledge about the factors that are contributing to this problem, in order to combat it as best as possible. Among the contributors to the condition is poor hygiene, especially handwashing in hospitals, where staff and patients do not follow the washing steps, nor do they apply gel alcohol. In addition, a wide range of physicians empirically prescribe antibiotics without first performing culture and antibiogram collection, as well as microbiology laboratories that lack adequate infrastructure, whether in equipment or qualified professionals. Therefore, it is necessary to have effective measures to combat the problem. It is important for prevention that the general population, as well as health professionals and other hospital workers, have general hygiene, such as care with hand washing and equipment sterilization. Vaccines also need to be up to date. The population should not arbitrarily reuse antibiotics left over from past treatments, there should always be medical indication in the use of these medications. For physicians, it is essential that antibiotic prescriptions come with adequate dosage and whenever possible perform antibiogram and culture collection. In addition, it is of paramount importance that the governors of different countries conduct campaigns aimed at informing the population correctly, as well as providing specific training for all health officials. If psychologists, physiotherapists, nurses and other professions have adequate and uniform knowledge  about the problem, there will be a correct dissemination of information to patients and the general population. Thus, with interprofessionality in vogue, it is possible to gradually minimize bacterial resistance. References Folha informativa – Resistência aos antibióticos [Internet]. [place unknown]: OPAS Brasil; 2017 [cited 2019 Nov 21]. Available from: https://www.paho.org/bra/index.php?option=com_content&view=article&id=5664:folha-informativa-resistencia-aos-antibioticos&Itemid=812. Superbactérias avançam no Brasil e levam autoridades de saúde a correr contra o tempo [Internet]. [place unknown]: BBC Brasil; 2017 [cited 2019 Nov 21]. Available from: https://www.bbc.com/portuguese/brasil-40561948. Ministério da Saúde desenvolve ações para buscar respostas contra resistência aos antimicrobianos [Internet]. [place unknown]: Ministério da Saúde; 2018 [cited 2019 Nov 21]. Available from: http://www.saude.gov.br/noticias/agencia-saude/42953-ministerio-da-saude-desenvolve-acoes-para-buscar-respostas-contra-resistencia-aos-antimicrobianos. Antimicrobianos. Boletim [Internet]. 2018 Junho [cited 2019 Nov 21];:16. Available from: https://www.infectologia.org.br/admin/zcloud/principal/2018/07/Boletim_SBI_Junho_2018.pdf. About the author Ketelly Bueno Koch, 21, fifth semester medical student at the University of Caxias do Sul. Member of IFMSA – Brazil since March 2019, currently holding the position of SCOME committee coordinator. Dedicated to research and always attentive to the news of the medical world. Active in social issues, mainly related to volunteer work, which she believes to be fundamental for academic education.