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Antimicrobial Resistance in Australia

Over hundreds of people died each year in Australia due to Antimicrobial Resistance, or AMR, and the number of death is still steadily increasing. AMR is a currently importantly serious threat to not only human but also animals in Australia and all around the world. People can be resistant to antimicrobial medicines at any age and anywhere. Antimicrobial Resistance happens when a microorganism (i.e. fungi, bacteria, viruses) evolves and gains ability to become more resistance or completely resistance to the medicine that was previously used to treat it. Drug-resistant bacteria are increasingly difficult to treat, requiring replacement or higher-dose drugs that may be more expensive or more toxic. Resistance can develop through one of the three mechanisms: natural resistant ability in some types of microorganisms, mutation in genes or receiving the resistance from another species. Antibodies appear naturally due to random mutations; or more often after gradual accumulation over time, and because of abuse of antibiotics. Multidrug-resistance, or MDR, are the microorganisms that are resistance to many types of antimicrobials. "Superbugs" is the term also used for multidrug-resistant microbes, or totally drug-resistant (TDR).

Causes

Antimicrobial Misuse

When antimicrobial drugs are used to kill microbes, not all of them die. Some, have the resistance gene, may still survive and are only weakened. As more antimicrobial of the same type is taken, the survived microorganisms start to gain resistance to it. The misuse of antimicrobial creates a natural selection condition under which those survived ones have a chance to reproduce and the drug-resistant bacteria are more common. When the recent dose does not affect anymore, we have to use a higher dose to kill microbes. Over time, the bacteria will become resistance with that particular antimicrobial medication.

Genetic Mutation

Genetic Mutation is known as one of the natural causes of Antimicrobial Resistance. Microorganisms can reproduce really fast by duplicating itself every period of time, which allowing them to have the ability to evolve and adapt to the changes of the environment. Every time a microbe goes into the reproduction process, there is a risk to have random errors in its genetic replication process, called mutation. These mutations can either positively or negatively affect the microbe itself. Genetic mutation could give the microorganism the ability to adapt, become resistant and multiply to the antimicrobial which are being used to kill them. Over time, the gene of resistance will become dominant and the population will be resistant to the antimicrobials.

Gene Transfer

Horizontal Gene Transfer is a process in which the microorganisms of the same species or from different species are able to share their gene with each other. Microorganism can communicate, exchange genes to each other. The known result for gene transfer is genetic variation and it could be a serious problem when they are also able to transfer the drug-resistance genes to each other. Bacteria are able to share genetic information to each other via three mechanisms: conjugation, transduction and transformation.

Mechanism

The effect of antimicrobial on microbes is disrupting the internal structures of the bacteria to stops them from reproducing or to kill them. The microbes gain resistance to the drugs by changing the structures to prevent their actions.

Microorganisms can resist antimicrobial by preventing the drug from reaching its target. Microbes can push away the antimicrobial out of the cell's body by creating pumps placed in the membrane, called efflux pumps. These efflux pump transport nutrient molecules in and out the cell and can be used to pump the antimicrobial out of the microbe. Other mechanism to withstand the action of antimicrobial is reduce the cell membrane's permeability, preventing the drug get through the cell membrane.