Superbugs are strains of bacteria, viruses, parasites and fungi that are resistant to most of the antibiotics and other medications commonly used to treat the infections they cause. A few examples of superbugs include resistant bacteria that can cause pneumonia, urinary tract infections and skin infections. They present major roadblocks to the effective treatment of common ailments and have resulted in several well-publicized hospital-based outbreaks in recent years. Several strains of bacterial superbugs exist and are in circulation in the population. The main strains include:
Methicillin-resistant Staphylococcus aureus (MRSA), Carbapenem-resistant Enterobacteriaceae (CRE), Vancomycin-resistant Enterococcus (VRE), Multidrug-resistant Acinetobacter and E. coli H30-RX.
According to the 2019 Antibiotic Resistance Threat Report, published by the Centre for Disease Control and Prevention (CDC), more than 2.8 million drug-resistant infections happen every year in the United States, and more than 35,000 of them are fatal. The CDC’s report lists 18 bacteria and fungi that endanger human health, classifying them as either:
- Concerning threats.
- Urgent threats.
Carbapenem-resistant Acinetobacter ,Candida auris ,Clostridioides difficile, Carbapenem-resistant Enterobacteriaceae andDrug-resistant Neisseria gonorrhoeae.
Serious threats
Drug-resistant Campylobacter, Drug-resistant Candida , ESBL (Extended Spectrum β- lactamase) producing Enterobacteriaceae, Vancomycin-resistant Enterococci (VRE), Multidrug-resistant Pseudomonas aeruginosa, Drug-resistant nontyphoidal Salmonella, Drug-resistant Salmonella serotype Typhi, Drug-resistant Shigella, Methicillin-resistant Staphylococcus aureus (MRSA), Drug-resistant Streptococcus pneumonia, Drug-resistant Tuberculosis.
Concerning threats
Erythromycin-resistant group A Streptococcus and Clindamycin-resistant group B Streptococcus. According to the World Health Organisation (WHO), by 2050 there will be more deaths related to superbugs than cancer and they will be the leading cause of death on the planet. The World Health Organisation itself has established three groups of multi-resistant bacteria, according to their priority.
In priority 1 or critical, where all are resistant to carbapenems, the so-called broad-spectrum antibiotics, are Acinetobacterbaumannii, Pseudomonas aeruginosa, some Enterobacteria such as Klebsiella pneumonie, Escherichia coli and several species of the genera Serratia and Proteus. In the case of Klebsiella, cases have already been found where no antibiotic is effective.
Priority 2 or high are Enterococcus faecium (vancomycin resistant), Staphylococcus aureus (methicillin and vancomycin resistant), Helicobacter pylori (immune to clarithromycin), Campylobacter spp. and Salmonella (both resistant to fluoroquinolones) and Neisseria gonorrhoeae (cephalosporin and fluoroquinolone resistant).
And finally, there is priority 3 or medium which includes Streptococcus pneumoniae (penicillin-insensitive), Haemophilus influenzae (ampicillin-resistant) and Shigella spp. (fluoroquinolone-immune).
Emergence of Superbugs
Causes of superbugs in veterinary medicine can be summarized in points:
- Overuse of antibiotics: Frequent and unnecessary use of antibiotics in animals can lead to the development of antibiotic-resistant bacteria. The use of antibiotics to promote animal growth is a common practice in some agricultural settings, which can contribute to antibiotic resistance.
- Misuse of antibiotics: Incorrect dosages, improper administration, and incomplete treatment courses can promote antibiotic resistance in veterinary settings.
- Suboptimal hygiene: Poor sanitation and hygiene practices in animal farming and healthcare facilities can facilitate the spread of resistant bacteria.
- Close contact between animals: High-density farming and close contact between animals can facilitate the rapid transmission of resistant bacteria.
- International trade in animals: The global movement of animals can spread resistant bacteria across borders and between regions.
- Limited veterinary drug options: In some cases, a lack of alternative veterinary treatments can lead to the overreliance on a few antibiotics, increasing the risk of resistance.
- Zoonotic transmission: Resistant bacteria in animals can potentially transfer to humans, leading to difficult-to-treat infections.
- Lack of surveillance: Inadequate monitoring and reporting of antibiotic use and resistance in veterinary settings can hinder efforts to control superbugs.
- Environmental contamination: Residues of antibiotics and resistant bacteria from animal waste can enter the environment, further contributing to the development of superbugs.
Control
Controlling superbugs in veterinary medicine is crucial to protect both animal and human health. Here are some key points on how to control superbugs in veterinary practices:
(i) Antibiotic Stewardship:
Implement strict guidelines for antibiotic use, reserving them for necessary cases.
Use antibiotics only when bacterial infections are confirmed through diagnostics.
(ii) Vaccination: Promote vaccination to prevent common bacterial infections in animals.
(iii) Hygiene and Biosecurity:
- Maintain rigorous hygiene practices to prevent the spread of infections.
- Isolate sick animals to prevent disease transmission.
- Regularly clean and disinfect animal facilities.
(iv) Surveillance: Establish surveillance systems to monitor antibiotic resistance in animal populations.
(v) Responsible Use of Antimicrobials:
- Use antibiotics with veterinary oversight and only when needed.
- Follow appropriate dosing regimens and withdrawal periods.
(vi) Alternatives to Antibiotics: Explore non-antibiotic treatment options, such as probiotics or phage therapy.
(vii) Education:
- Train veterinarians and animal caretakers on responsible antibiotic use.
- Raise awareness among farmers and pet owners about the importance of antibiotic stewardship.
(viii) Research: Invest in research to develop new antibiotics and alternative treatments.
(ix) Regulatory Measures:
- Enforce regulations on antibiotic use in veterinary medicine.
- Restrict the use of critically important antibiotics.
(x) Collaboration: Collaborate with human healthcare professionals to address the One Health approach, recognizing the interconnection between animal and human health.
By implementing these measures, veterinarians and stakeholders can contribute to the responsible use of antibiotics and the control of superbugs in veterinary medicine.
(Author is Senior Assistant professor, Division of Veterinary Medicine SKUAST Kashmir)
