Antimicrobial Resistance Q&A With Dr. Azeem Ahmad
Azeem Ahmad, Ph.D. answers the most pressing questions about antimicrobial resistance (AMR) and shares his perspective on how humanity can address and overcome this crisis.
Q1: Has the increased use of sanitizers during the COVID-19 pandemic affected antibiotic resistance?
Answer: "I think one of the things people should know that any kind of chemical that will be able to kill bacteria, or change bacteria genetically, like its DNA is manipulated somehow (we know that sunlight can do that, UV rays from sun). But also other chemicals around us that we use daily can actually do that. And sanitizers are also one of them. And I think in this COVID pandemic we have used a lot more sanitizer, which means, basically, again that there is an opportunity for these organisms to have their DNA manipulated or accumulate mutations in them. And that will make them resistant to these agents.
So if you use too much of the sanitizer, you are actually giving them an opportunity to resist that. We recognize some of these bacteria which are opportunists. I think these will be the first ones which will try to take advantage of this situation. So limit the use of sanitizers, limit the use of all kinds of microbial control methods. Because not all organisms around you are pathogens and they are not harming you."
Q2: How much of a contributor to AMR is animal usage of antibiotics?
Answer: "There are many factors to AMR or antibiotic or antimicrobial resistance, but animal husbandry or animal products is one of the biggest ones. Food shortage is a major thing. I think that pressure actually led to the farmers, who have started using growth hormones, to actually make more beef or meat or pork or poultry or chicken. All of these different meat products, or animal products, and they used growth hormones for it, plus antibiotics to prevent disease. The majority of these are used for basically not treating diseases but treating basically those conditions in which the animals are living. For example, the sanitation is not that good. This is a major factor.
I think in future, what we need to do is try to find a solution for these farmers to have some kind of guidelines which are protected by legislation and protected by rules and policies, that are consistent throughout nationally or when we are talking about different countries, internationally under World Health Organization. I believe that going forward, animal husbandry needs to be in a better condition to actually help animal contribution towards antimicrobial resistance spreading in the environment."
Q3: What can individuals do to combat AMR?
Answer: "With today’s world in which we are living, inside a pandemic, what I can think of is, wear a mask. We saw a huge increase in use of antibiotics because of COVID. Not only that physicians were unsure what to do with flu-like symptoms, but people were really scared and they wanted to actually know whether they can take an antibiotic. An example would be azithromycin, I think it was used a lot and prescribed. So wearing a mask is actually going to reduce indirectly the antibiotic use, and that antibiotic use means less antibiotics in the environment and less antimicrobial that developed in these organisms."
Q4: Are bacteriophages a viable strategy to combat AMR in the future?
Answer: "Yes, bacteriophages are a viable strategy for a future fight for reducing AMR. There are many properties of phages that actually help us do that. There is high specificity when you talk about the phages. They only infect the specific bacteria that they are against. So that takes into account that there is no damage to the host as well as to the other bacteria, which might be beneficial bacteria in your body.
Beside that, I think it is easier to find in nature than actually finding new antibiotic drugs or molecules that are novel. So I feel that with our technology advancing so much in environmental studies, I think it will be much easier to find these phages, which are more effective against the pathogens or clinical infective particles that are very very needed in today’s work."
Q5: What are the best- and worst-case scenarios going forward with AMR?
Answer: "I think just spreading the hope that we can actually win this fight is important. My hope is that people’s attitudes will change and see that AMR is not something that is unconquerable. It is something that we can do something about.
It happens and starts with hospitals, health facilities, nursing homes- try to identify people who are more vulnerable. And also, help the industry a little bit to develop new technologies and incentivize them to invest in it. I know we have to have, no matter what, we have to have some kind of backup. God forbid if we get into a situation where nothing is working for very normal common infections.
I remember a couple of years ago there was a woman, that she got an infection after a hip surgery and basically things got worse and worse for her. And she ultimately died because none of the 26 antibiotics that were actually there were able to treat her. So what I’m trying to emphasize is, do not think that this is unreal. This is actually real stories. There are many many more where we were unable to actually to treat infections, which were common infections in people and they lost their life.
We need very concerted efforts, not only just nationally but internationally. And if we do that, there is no doubt in my mind that certainly this will lead to areas where people will cooperate and help the situation. Where AMR is going to be behind us pretty soon."