World Microbiome Day & Antimicrobial Resistance

Author: Melissa Raassina & Rebecca Morehouse
Date: 26th June, 2019
In celebration of World Microbiome Day, we’re discussing all things microbes and antibiotic resistance! Many people are asking, what happens if antibiotic resistance continues to spread? And how can we prevent antibiotic resistance from spreading further?

Why?

Antimicrobial resistance, more commonly known as antibiotic resistance, is a big issue facing the population on a global scale. The potential for worldwide disaster is larger than one would think, with the current death toll sitting at 700,000 per year, and predicted to reach 10 million deaths per year, by 20501.

What is antibiotic resistance?

Antibiotic resistance occurs through the misuse or overuse of antibiotics in humans or animals. The World Health Organization (WHO) explains that it’s the bacteria that become antibiotic-resistant and not the humans or animals. This means that when antibiotics are used, they not only kill the bacteria causing an illness, but they can also kill the beneficial bacteria which protect the body from infection. This leaves room for the resistant microbes which survived the antibiotic treatment to thrive. They are able to re-produce in large numbers and pass on their antibiotic resistance, making it more difficult for the microbiome to recover. The most concerning part is that these antibiotic-resistant bacteria can result in infections that are harder to treat than those caused by non-resistant bacteria2.
It’s important to note the vital role that antibiotics play in modern medicine – and that should never be debated or watered down. Antibiotics certainly have an important place in modern-day society. The simple access to antibiotics means that diseases and illnesses that once resulted in potential death or permanent damage, are now treated with a simple course of antibiotics that your doctor can give you in a 15-minute consultation.
However, it is this simple access to antibiotics that has also resulted in overuse – and even misuse in some cases. Frequent use of antibiotics can cause an almost complete eradication of bacteria in your gut microbiome. This may take up to 6 months to fully recover – leaving the gut susceptible to a lowered diversity of beneficial bacteria and the colonisation of undesirable bacteria.
Some of these “undesirable bacteria” in the gut and the rest of the human body can develop resistance to antibiotics, making it harder to treat bacterial illnesses. It’s this antibiotic resistance that is spreading on a global scale and causing very serious issues.

What is the problem?

According to the WHO, antibiotic resistance is reaching dangerously high levels in certain parts of the world. They list common infectious diseases that are now “at risk of lowered treatment options”. These diseases include pneumonia, tuberculosis, foodborne diseases and blood poisoning. Just think, one day you may go to the doctor with pneumonia and not be able to receive treatment because the microbes you host have become resistant to antibiotic treatments. A simple illness then becomes potentially life threatening for some people2. What a big step back to the past that would be!
There are several contributing factors to the spread of antibiotic resistance, such as antibiotics bought without a prescription, the unnecessary use of antibiotics (such as to treat viral cold and flu), countries with no standard treatment guidelines, or even the sharing of antibiotics.
As the Ad hoc Interagency Coordination Group on Antimicrobial Resistance stated in their report to the Secretary-General of the United Nations in April 2019, “there is no time to wait. Unless the world acts urgently, antimicrobial resistance will have a disastrous impact within a generation3.”
With the potential to set medicine back more than a century in a relatively short time period, antibiotic resistance must be recognised as a widespread and urgent issue requiring immediate attention from the many, not the few.

What does the future look like?

Do not fear, action is near.
Although antibiotic resistance is not an issue that can be solved overnight, there are now researchers working to address the problem. One group in Australia, led by the University of Technology, Sydney, is about to get to work on building a knowledge engine focused on antibiotic resistance.
The Australian Government’s Medical Research Future Fund (MRFF) financed a $1 million boost through its Frontier initiative for 26 researchers to work for an initial one-year period on tackling antimicrobial resistance. These researchers come from 13 organisations, including Australian leader in gut microbiome analysis, Microba. This group of researchers will work to develop an antimicrobial resistance (AMR) ‘knowledge engine’ that, by using smart algorithms and machine learning, will track, trace and predict outbreaks of AMR and inform interventions.
Named OUTBREAK (One-health Understanding Through Bacterial Resistance to Antibiotics Knowledge), and headed by Professor Steven Djordjevic of UTS, this software will be used to reduce the risk of AMR in humans and animals who often rely on many of the same antibiotic medications.
As specialists in whole genome sequencing and metagenomics, Microba will provide key expertise to this project which will encompass a range of scientific areas to help produce the OUTBREAK system. This is potentially the key to saving millions of lives in the future.
The buy-in from governments such as Australia’s, magnifies the impact that such software could have on a global scale. The aim of OUTBREAK is to be able to see different and localised data streams, allowing the software tool to be tailored at a geographical or sector level. Not every town or city is the same, so they will have different risks and require potentially different solutions or plans of attack.
Although in its infancy, this project’s vision is to create a worldwide artificial intelligence-powered network for AMR surveillance and mitigation. While this is no small feat, the Australian research team are certainly up for the job. Should they show strong promise, they may receive a second round of funding from the Australian Government to develop the software further.
Through projects such as this, we see a relatively small group of researchers from a comparatively small population, taking on a global problem. To see real, tangible impacts in the lives of millions across the world will be something to celebrate together, indeed.

References:

  1. The Ad hoc Interagency Coordination Group on Antimicrobial Resistance. (2019). No time to wait: Securing the
    future from drug-resistant infections. Report to the Secretary-General of the United Nations. Summary of
    recommendations and key messages, p.4.
  2. World Health Organization. (2018). Fact sheet: Antibiotic Resistance. World Health Organization website.
    https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance [accessed 21/06/19]
  3. World Health Organization. (2019). No time to wait: Securing the future from drug-resistant infections. Report to
    the Secretary-General of the United Nations. Summary of recommendations and key messages, p.4.
  4. APC Microbiome Ireland. (2019). World Microbiome Day website. https://worldmicrobiomeday.com/ [accessed
    21/06/19]
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