Antibiotic Resistance: Everyone's Problem

[This article has been published in Spanish in the Huffington Post]

Antibiotic-resistant bacteria cause around 30,000 deaths in the US and a slightly higher number in Europe

We are in November and, as every year, we celebrate the World Antibiotic Awareness Week. Some may still ask themselves: why do we have to dedicate an entire week to this issue? Well, because antibiotic resistance has become a globally recognised public health emergency. Antibiotic-resistant bacteria cause around 30,000 deaths in the US and a slightly higher number in Europe, with Spain being one of the European countries with most cases and around 1,800 deaths every year.

In addition to these alarming figures, the economic impact is considerable: complications arising from this situation can cost up to 3,500 million USD – around 3,070 million Euros- to each high-income country, according to the recent Stemming the Superbug Tide report by the Organisation for Economic Cooperation and Development (OECD).  It is obviously time to react and take the necessary measures.

World Antibiotic Awareness Week/ WHO's advocacy material

What has led us to this situation? Antibiotic misuse and abuse, together with over-prescription and self-medication practices over the last years

What has led us to this situation? Antibiotic misuse and abuse, together with over-prescription and self-medication practices over the last years, have favoured the emergence of resistant bacteria and, in consequence, a rise in the number of infections caused by these microorganisms resistant to available treatments. 

But, in addition to the emergence of antibiotic resistance, another factor that makes this a global problem without borders is the spread of these resistances; in other words, the spread of the antibiotic-resistant genes and the pathogens that contain them. Bacteria are transported from one place to the other via food, animals for consumption, but also via our body: they move with us and, together with our luggage, we make them   travel. 

A paradigmatic example is a group of broad-spectrum beta-lactamases that confer resistance to carbapenems

A paradigmatic example is a group of broad-spectrum beta-lactamases that confer resistance to carbapenems, antibiotics used as last-resort when the infection does not respond to conventional treatments. They are called NDM, after “New Delhi metallo-beta-lactamase”. And why such an exotic name? Because it was first described in a Swedish patient returning from India, where he had been treated for a urinary infection in a New Delhi hospital. 

Since then, a great number of strains isolated from hospital patients in different places of the world, have been described. In most cases, it concerns travellers that have returned from the Indian subcontinent. 

In Spain, our team led by Dr. Jordi Vila, director of the Antimicrobial Resistance Initiative at ISGlobal, was the first to describe in 2011 an NDM-1 case isolated from a patient returning from India and suffering from strong diarrhoea, abdominal pain and fever, or the so-called traveller’s diarrhoea. 

Another study published in 2014 by our group collected data from patients returning with this kind of diarrhoea from tropical and subtropical countries between 2009 and 2011, and showed that India was the destination most associated to resistant bacteria. 

Dr. Ignasi Roca have launched an study that aims to determine the prevalence of these resistance determinants among patients that return with traveller’s diarrhoea

But, what is the current situation, almost one decade later? To answer this question, Dr. Ignasi Roca, in collaboration with the Tropical Medicine and International Travel Service at the Hospital Clinic of Barcelona, have launched an study that aims to determine the prevalence of these resistance determinants among patients that return with traveller’s diarrhoea. 

This type of studies are crucial to help us understand how these bacteria spread globally and identify the hot-spots where they concentrate in order to take the adequate measures to contain them and avoid their spread to hospitals and communities.    

If you return from travel and find yourself with diarrhoea, you can contribute to this study by going to the Tropical Medicine and International Health Service at the Hospital Clínic of Barcelona

Therefore, the more data we collect, the more robust will be the results. So, if you return from travel and find yourself with diarrhoea, you can contribute to this study by going to the Tropical Medicine and International Health Service at the Hospital Clínic of Barcelona.

Resistance is a problem that affects us all, and you can contribute to its solution!