Antibiotic Resistance: Why Is This a Big Deal?

cdc.gov

Here is a nice article published online in American Medical News that provides a very nice overview of the problem of antibiotic resistance. The article also links to a consensus statement by 26 major health groups (including the CDC, Infectious Diseases Society of America and American Academy of Pediatrics, to name a few) that outlines the nature of the problem and commits to begin combatting the issue more aggressively, in a coordinated fashion, via promoting improved utilization of antibiotics, calling for new antibiotics to treat resistant infections and raising awareness about this issue in general. This is an excellent "call to arms" that both raises awareness about this issue and commits to a coordinated approach to addressing it.

Notably missing from the list of organizations that signed this statement, however, are major agricultural groups; as previously discussed, the majority of antibiotics are used in animal husbandry. The problem of antibiotic resistance truly crosses disciplines, and solutions to this issue will accordingly need to involve professionals across diverse fields such as agriculture, medicine, public health, economics, sociology, et cetera (the previously mentioned "One Health" approach to addressing issues with global impact).

A "One Health" Approach to Antibiotic Resistance

cdc.gov

This is a nice post highlighting the recent symposium "A One Health Approach to Antimicrobial Use & Resistance: A Dialogue for a Common Purpose" that was coordinated by the National Institute for Animal Agriculture. This meeting brought together experts in antibiotic resistance from numerous disciplines (following the "One Health" approach that emphasizes interdisciplinary coordination to address global health issues). 

The following were the 'take home points' from the conference: antibiotic resistance is not a new phenomenon, the issue is complex and involves more than just its health implications (also has social, political and economic implications); all communities that use antibiotics are responsible for antimicrobial stewardship; people from all disciplines need to work together to address this important issue. 

The call for a coordinated, interdisciplinary response to antibiotic resistance is sound and necessary; improved antibiotic use in humans is important but the issue must also be addressed in animal populations where the majority of antibiotics are used. The One Health approach emphasizes that experts across the board (veterinarians, physicians, economists, et cetera) and around the globe need to work together to address the issue.

One thing is certain: the time to get aggressive with battling antibiotic resistance is now. We have essentially run out of new antibiotics to combat many resistant infections, and perhaps are nearing the dreaded 'post-antibiotic era.' Although a recent survey by the Pew Health Group indicated that many Americans are aware of the issue of antibiotic resistance, this issue is largely not viewed as a major public health crisis (which it is). 

You can test your knowledge about antibiotics here. 

Investigating Unidentified Liver Disease (ULD) in Ethiopia: a Testament to the “One Health” Approach

http://www.cdc.gov/nceh/stories/Ethiopia.html

According to their website, the “One Health concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.” It is an über-collaboration designed to pull from a host of different disciplines to address health issues that cut across disciplines, and is supported by a number of major organizations. 

An example of a “One Health” approach to addressing health issues is the investigation of Unidentified Liver Disease (ULD) that was first reported in northern Ethiopia in 2002. Epidemiologists and scientists from the CDC, the USDA, the Ethiopian Ministry of Agriculture, Addis Ababa University, the Chinese University of Hong Kong among other groups all worked together to solve this mystery, ultimately finding that the disease was due to toxic pyrrolizidine alkaloids that people were exposed to when their fields were not properly weeded. Grain farmers in this region now have the information they need to prevent this illness. Although this investigation does illustrate remarkable collaboration across multiple organizations and countries, another striking feature is the time it took to identify ULD’s etiology-around 6 years from the initial investigation in 2005 until a firm epidemiologic link was established in 2011. Arguably, however, this link likely would not have been elucidated without the close collaboration of the numerous groups involved in this investigation. 

The “One Health” movement is intriguing and the close collaborations it espouses will be critical to addressing critical health issues that cut across disciplines, such as antibiotic resistance.