Hospitals are commonly recognized as hubs for patient care that provide safety, encourage health, and promote happiness. Despite their positive connotations, hospitals are unwitting contributors to one of the world’s fastest-growing public health crises — antibiotic resistance. Since the ancient usage of dyes, molds, and heavy metals for infection treatment to the creation of modern era antibiotics in the 1900s, the world has relied heavily on these compounds in fields such as healthcare and farming. As a result, this dependence has fueled the rapid emergence of antibiotic-resistant microorganisms and bacterium, which poses an immediate threat to modern medicine practices, patient health and well-being, and global infection prevention.
Looking at the origins of modern-day antibiotic resistance helps to illuminate the threat it poses for public health as well as the need for intervention. There are two types of antibiotic resistance: spontaneous and transmitted. Spontaneous resistance arises from bacterial genetic mutations, while transmitted resistance spreads from one individual to another (Professional, n.d.). Transmitted resistance is common in hospitals, where resistance can emerge through the process of conjugation, a method of gene transfer involving cell-to-cell contact (Munita & Arias, 2016).
Consider Candida auris (C. auris), an antibiotic-resistant fungus that over 200 residents of Michigan contracted in April 2023 (Michigan Department of Health and Human Services, 2023). C. auris is a type of yeast that emerges in healthcare facilities through contact with contaminated equipment, surfaces, or through physical contact with someone who has C. auris (“Candida auris”, 2023). Those at the greatest risk of C. auris infection are patients hospitalized for long periods, patients that have received antibiotics or antifungal medicines, and patients that have lines or tubes entering their bodies (“Candida auris”, 2023). Many individuals who contract C. auris only develop a passive, and non-illness-causing infection. However, when the fungus enters the bloodstream it gains access to an individual's entire body. With this gateway, C. auris can cause an active and illness-causing infection, which can lead to severe illness and occasionally death in hospitalized patients (“Candida auris”, 2023). Over 65 of the 200 infected individuals in Michigan developed an active C. auris infection. (Michigan Department of Health and Human Services, 2023). Furthermore, due to the antibiotic resistance of the fungus, medical professionals encounter difficulties when treating C. auris infections, which are characterized as very serious and largely invasive (CDC, 2022). This example sheds light on a specific case of antibiotic resistance in the midwestern United States. However, the frequency of infections caused by antibiotic resistance are wide-ranging and continually increasing. In the United States alone there are roughly 2.8 million antibiotic resistant infections reported annually, with over 35,000 deaths suffered as a result (CDC, 2022).
We can also highlight the need for action by examining the impact of antibiotic resistance internationally. In 2019, the Centers for Disease Control and Prevention reported approximately 5 million deaths worldwide that were associated with antibiotic resistance in microbes (2022). A specific case to consider is the antibiotic resistance in tuberculosis-causing bacterium. On a global scale, 4.1% of tuberculosis (TB) infections are multidrug resistant (resistance to more than one type of antibiotic), presenting a challenge for countries with high TB rates such as India, South Africa, Russia, and the Philippines (Dadgostar, 2019). It is crucial to acknowledge the potential that antibiotic resistance has to jeopardize the healthcare industry’s ability to treat common infections, which can escalate the spread of infectious diseases. Thus, it is imperative to recognize the urgency of this issue, and understand how it undermines modern medicine.
Consequences of antibiotic resistance affect both patient well-being and the foundations of healthcare systems worldwide. For patients, infections created by antibiotic resistance lead to serious illnesses, prolonged hospital stays, and increased medical expenses (CDC, 2022). When antibiotics falter, patients face greater risks with second and third-line treatments. This often involves newer and more expensive drugs to ensure treatment success (Office of the Commissioner, 2019). Beyond the scope of individual health, society’s ability to fight common infections arising from procedures, such as organ transplants, joint replacements, cancer therapy, and chronic disease treatments, is dependent on antibiotics (World Health Organization: WHO, 2020).
In order to combat increasing antibiotic resistance, policymakers must prioritize surveillance of antibiotic resistant infections and consult scientists, physicians, and epidemiologists proactively to establish guidelines that prepare countries with steps to take and resources to use in response to future antibiotic-resistant outbreaks. Simultaneously, public awareness campaigns should be funded to educate individuals on the proper use of antibiotics, and should be paired with stricter labeling regulations on antibiotic medications. Another factor to invest in is resource allocation towards developing and approving new antibiotics to ensure modern medicine evolves correspondingly with bacteria.
As global citizens, we also play a vital role in this battle. Patients should avoid demanding antibiotic treatment when deemed unnecessary by a healthcare professional and explore alternative therapies instead. Also, individuals should practice good hygiene, like regular hand washing, and get recommended vaccines that can protect them from viral infections. By avoiding viral infections, we can eliminate symptoms that may prompt unnecessary antibiotics use.
Overall, we must not underestimate the rising problem of antibiotic resistance. The world’s healthcare systems are tightly linked to antibiotics for infectious disease treatment, and we must not treat antibiotics as common medications. To ensure a sustainable future for global healthcare, we must emphasize collective action, accountability, and informed-decision making immediately.
References
Candida auris (C. auris). (2023). Retrieved November 21, 2023, from Illinois Department of Public Health website: https://dph.illinois.gov/topics-services/diseases-and-
CDC. (2022, October 5). What Exactly is Antibiotic Resistance? Centers for Disease Control
and Prevention. https://www.cdc.gov/drugresistance/about.html
Cleveland Clinic. (2023). Antibiotic resistance. Cleveland Clinic.
Dadgostar, P. (2019). Antimicrobial resistance: Implications and costs. Infection and Drug
Resistance, 12, 3903–3910. https://doi.org/10.2147/IDR.S234610
Michigan Department of Health and Human Services. (2023). Candida auris. Retrieved
November 21, 2023, from https://www.michigan.gov/mdhhs/keep-mi-
Munita, J. M., & Arias, C. A. (2016). Mechanisms of antibiotic resistance. Microbiology
Spectrum, 4(2), 10.1128/microbiolspec.VMBF-0016–2015.
Office of the Commissioner. (2019). Combating antibiotic resistance. U.S. Food and Drug
Administration. https://www.fda.gov/consumers/consumer-updates/combating-
World Health Organization: WHO. (2020, July 31). Antibiotic resistance. World Health
Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/antibiotic-