Bacterial antibiotic resistance may become leading cause of deaths
The huge bacterial population living inside more complex organisms (humans, livestock), constitutes units that are both independent and partly connected to each other, primarily through the bacterial populations living in our environment – explained to the scientific portal Laboratorium.hu László Branduse, Managing Director of VetControl, member of the Eurofins group. Active substances of antibiotics released into the environment are extremely dangerous: according to forecasts of European authorities diseases caused by multi-resistant bacteria may become the leading cause of death in Hungary by 2050.
What exactly is multi-resistance?
Survival and reproduction are the main objectives of all living organisms, including bacteria. The more antibiotics mankind uses, the more will be released into the environment in the form of active substance, eradicating susceptible bacteria and providing an advantage for resistant ones in the fight for survival. Consequently, pathogens against which treatment is difficult or impossible, will proliferate. (One such example is the methicillin resistant Staphylococcus aureus, which is resistant to all antibiotics of the penicillin and cephalosporin groups).
Resistance is a consequence of natural genetic modification which is passed on to the next generations. Even more importantly, it is often linked to the extranuclear genome (so-called plasmids) which may even be passed on between bacteria of different or completely unrelated species, ensuring rapid and efficient spreading of the resistance.
It should be clear – said László Branduse, Managing Director of VetControl, member of the Eurofins group, an international market leader laboratory network – that the huge bacterial population living in more complex organisms (humans, livestock) constitutes partly independent, delimited units (i.e. humans, pigs, dogs, chicken have their respective species-specific sets of bacteria), which are, however, partly interconnected with each other, primarily through the bacterial populations living in our environment.
Accordingly, the environment is a repository, and a venue of exchange and spreading, of genes that are responsible for resistance. In other words, resistant bacteria evolve not only in the individual – person, animal or plant – which is actually treated with antibiotics, but also in the environment. This is why active substances of antibiotics, released into the environment, are dangerous. The problem comes to a head when the multi-resistant conditional pathogen proliferates in a human (or animal) body whose immune system has weakened for any reason, and causes a disease.
The immune system may be weakened by a variety of factors: other contagious diseases (e.g. flu, COVID), tumours, transplants or protracted application of medicines (e.g. steroids). In such cases the disease caused by a multi-resistant bacterium cannot be cured by applying antibiotics because of the resistance and the patient finally dies.
As a result, any disease caused by multi-resistant bacteria may become the leading cause of death across the world by 2050. The health of humans, animals and the environment, is one and the same thing after all – as is correctly declared by the “One Health” initiative whose mission is to halve the use of antibiotics by 2030, says László Branduse.
What should antibiotics be administered against?
Antibiotics are ineffective against viruses; their use for a viral infection may only be justified where the doctor can be certain that there is a bacterial coinfection. Antibiotics should only be applied in treating bacterial contagious diseases. Preventive treatment is very rarely justified, e.g. before major operations.
Hardly have a hundred years passed since the discovery of penicillin – it goes to show how quickly medical science is changing. In parallel with veterinary medicine, the increasingly dominant trend is that antibiotics are not administered at once.
It is key, therefore, that antibiotics should only be taken if it is absolutely necessary!
As an animal health diagnostics laboratory VetControl also provides the laboratory background for promoting conscious and targeted use of antibiotics (i.e. not very broad-spectrum products), in line with the relevant regulation.
One is not allowed to shoot with a shotgun in a shooting gallery either – as Mr. Branduse aptly noted to illustrate the importance of targeted application of antibiotics.
Leading cause of deaths by 2050?
Like in the case of humans, it does matter when and for what diseases antibiotics may be administered to animals. A joint report of three EU agencies on changes in the consumption of antibiotics and the development of antibiotic-resistance in Europe, may give rise to hope. According to the report the use of antibiotics has decreased to varying degrees in most EU Member States; in some cases the use of antibiotics on livestock is even below its human use. Unfortunately, the decrease is less pronounced in Hungary, being the fifth among the Member States in terms of the rates of antibiotics use in livestock production.
The decrease in the use of antibiotics shows the effectiveness of actions taken at a national level. The use of the polymyxins group of antibiotics which includes colistine, for instance, dropped by nearly fifty percent on an average in the EU between 2016 and 2018. This is a positive development because colistine is used in hospitals as well, for treating certain patients with multi-resistant bacterial infections, according to a communication released last summer by the European Food Safety Authority (EFSA), the European Medicines Agency (EMA and the European Centre for Disease Prevention and Control (ECDC). It should be noted however, that no such marked decrease has been observed in Hungary: Diseases caused by multi-resistant bacteria may become the leading cause of death in Hungary by 2050
Antibiotics not only in the body but also in our environment
Experience shows – in both humans and animals – that antibiotics are often administered in larger than the necessary dosages. Indeed, in many cases there may not even be a need for antibiotics. Excessive quantities however, definitely cause harm because it ends up in wastewater, or in the case of livestock, in the manure, which is then incorporated in the soil, or in other words, the environment. This is why the EU regulation prohibits the preventive use of antibiotics – said the Managing Director of VetControl, adding that Hungarian farmers are also making increasing efforts in this regard.
Is the antibiotic treatment of animals a hazard for humans?
Strict regulations stipulate that only antibiotic-free animal products (meat, dairy, eggs) may be marketed for human consumption. This is the aim of the withdrawal period regulation specifying for every antibiotic product the period of time that must pass after its last administering before the product is suitable for human consumption. Compliance is strictly controlled by testing foodstuffs for antibiotic residues, therefore the actual and considerable hazard to human health lies – contrary to popular belief – not in the consumption of animal products containing antibiotics but, on the one hand, the not sufficiently sound and careful use of antibiotics in human medicine and, on the other hand, the above mentioned environmental antibiotic pollution and the resulting spreading of resistance.
Awareness raising among people (as consumers of animal products and as keepers of pets) regarding the need for prudent and careful use of antibiotics: no antibiotics should be given to people or pets without first having a microbiological test carried out. This is a new direction but this is the only way towards long term health – concluded László Branduse.
An interesting presentation will be delivered soon at the Hungalimentaria food safety conference and exhibition as well (the event takes place at Aquaworld Resort Hotel on 18 and 19 April).