Anti-Microbial Resistance and Prevention

ANTI-MICROBIAL
RESISTANCE AND
PREVENTION
Group members
1. Khadar Yousuf Abdi
2. Haboon Abakor Qaliinle.
3. Muwaahib Mahamuud Ahmed.
Presentation overview
 Definition
 Mechanism of Action
 Factors Contributing to AMR
 Consequences of AMR
 AMR prevention & Containment.
Definition
 Antimicrobial resistance (AMR) is the ability of microbes
to grow in the presence of a class of drugs known as
antimicrobials that would normally kill microbes or limit
microbial growth. It occurs when microorganisms such as
bacteria, viruses, fungi and parasites change in ways
that render the medications used to cure the infections
they cause ineffective. Some microbes are resistant to
almost all types of antimicrobials. When the
microorganisms become resistant to most antimicrobials
they are often referred to as “superbugs.”
Process of Antimicrobial Resistance
 Basically there are four main mechanisms by

which these processes occur.
1.Drug inactivation (enzyme inactivation)
2.Cellular access (decrease permeability)
3.Site modification (altered target site)
4.Biochemical feedback ( by pass).
1.Drug inactivation
• The mechanism is a process by which bacterial
enzymes either completely destroy the
antimicrobial or modify the drug by adding a
molecule to it and rendering it capable of
specific activity.
e.g. beta-lactamase, which destroy the Beta-lactam
ring.
Cont..
Cont..
cont..
2.Cellular access
• The mechanism is controlled in terms of
allowing entry to the bacterial cell, or an active
process of ejecting drugs via an efflux pump.
• Efflux pump mechanisms are increasingly
recognized as a common method by which
bacteria can remove a wide range of
antimicrobials.
Cont..
Cont..
3.Site modification
 Site modification-involves alteration of the
target site of an antimicrobial agent so that the
fit is no longer sufficient to exert activity
Cont..
Cont..
4.Biochemical feedback
 Biochemical feedback-via target
hyperproduction is best represented by the
folic acids pathwey in which an organism may
deliberately over-produce an enzyme so as to
saturate all the sulfonamide or trimethoprim
present and still be able to catalyze the
biosynthetic pathway.
Cont..
Factors Contributing to AMR
 Antimicrobial resistance is the result of many
factors with biological, behavioral, technical,
economic, regulatory, and educational roots.
But among all these factors, irrational use of
antimicrobials is the greatest driver of
resistance.
Cont..
 The irrational use of antimicrobials practices
which contribute to the development of AMR
include, but not limited to the following:
 Unnecessary prescription of antibiotics, such as
for viral infections (colds) or for prolonged
prophylaxis
 Using broad-spectrum antibiotics (such as third
generation cephalosporin’s, carbapenems) when
narrow-spectrum antibiotics are effective
Cont..
 Prescribing too low doses
 Not prescribing according to microbiology
results/absence of diagnostic facilities
 Prescribing intravenous therapy when oral therapy
is known to be effective and clinically safe
 Omitting or delaying administration of doses and
not taking antibiotics as prescribed by patients.
 Limited access to health care.
Cont..
 Antimicrobials available without prescription
and irrational self-administration
 Accessible but poor quality, sub-standard or
counterfeit antimicrobials
 Weak monitoring and regulatory systems
 Poor infection control systems in health facilities
 Economic incentives for prescribers and
dispensers (un ethical promotions).
Consequences of AMR
 Antimicrobial resistance is responsible for
countless human deaths and billions of dollars
in healthcare expenses. Many patients around
the world suffer harm due to AMR because
infections (caused by viruses, bacteria, fungi,
protozoa, or helminths) are no longer
susceptible to the common medicines used to
treat them. The following points summarize
the consequences of AMR.
Cont..
  Increased morbidity & mortality
  Longer duration of illness:
  Longer treatment
Excess length of stay 6.4 – 12.7 days/patient
 Treatment with expensive drugs
 Increased burden on health system
 Negates technological advances in medical sector.
Complex surgeries
Transplantations and other interventions
Cont..
 Patient acts as reservoir of resistant organisms
which are passed to community and health-
care workers
 Huge economic impact (both direct & indirect.
AMR prevention & Containment
 Recognizing the public health crisis due to

AMR, several nations, international agencies,
and many other organizations worldwide have
taken action to counteract it through strategies
applied in the relevant sectors.
Cont..
1. Raise awareness and understanding and
improve education on antimicrobial use,
resistance prevention, and containment
through effective communication and
training.
2. Strengthen the knowledge and evidence on
antimicrobial use and resistance through one-
health surveillance and research.
Cont..
3. Improve infection prevention and contain the
spread of resistant microorganisms across human
and animal communities and health care settings
through individual and environmental sanitation,
hygiene, and infection prevention measures.
Cont..
4. Optimize the use of antimicrobials in human
and animal health through effective stewardship
practices.
5. Strengthen and establish national alliances
and partnerships, management and governance
arrangements, and resource mobilizations for
the prevention and containment of AMR at all
levels.
THANK YOU

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ANTI-MICROBIAL

 Basically there are four main mechanisms by

 Recognizing the public health crisis due to

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