Antimicrobial resistance, the next global public health challenge?

A common misconception is that it is the body that becomes resistant to microorganisms, which is wrong, as antimicrobial resistance (AR) occurs when microorganisms such as fungi or bacteria develop the ability to 'defeat' substances designed to eliminate them, which means that the pathogens continue infecting the organism and, yet more worrying, developing.  

The difficulty of this resistance lies in the fact these infections are very complicated and often impossible to treat. Every year in the U.S. alone, 2.8 million people and 670,000 in the E.U. suffer from an antibiotic-resistant infection, and deaths are estimated at 35,000 and 33,000 respectively.  

This issue has the potential to affect anyone, regardless of age or health condition, although it is true that people with chronic diseases are at especial risk. AR is also relevant in sensitive situations such as organ transplants, oncological therapies and chronic disease treatments.  

Why does AR occur? 

Due to the ubiquity of microorganisms, some of which are harmless and others pathogenic, their resistance strategies are of concern, which include restricting access to, directly eliminating, changing, destroying, avoiding or even modifying the targets of antimicrobial substances.  

And the fact is that any antibiotic can give rise to resistance, as these traits can be inherited from generation to generation through mobile genetic elements as well as transduction, conjugation and transformation processes.  

While it is true that AR occurs naturally due to mutations in the genes of microorganisms, the overuse and inappropriate use of antimicrobials accelerates the spread of resistant pathogens, which is why the Delegated Regulation (EU) 2021/1760 was published in early October with criteria for the designation of antimicrobials with reserved use for human health.