Antibiotic resistance problem grows amidst COVID-19 pandemic

Antibiotic resistance is a growing problem in medicine that may be combated by proper handwashing emphasized during the COVID-19 pandemic.

Handwashing campaigns, vital to the containment of COVID-19, could be maintained in the years to come to keep antibiotic resistant infections from becoming a global crisis.

“Antibiotic resistance is going to be the biggest threat to public health over the next five years—and beyond,” said Dr. Amesh Adalja, an infectious disease specialist and senior associate of health security at Johns Hopkins University.

According to Jim O’Neill, chair of the UK’s review into antimicrobial resistance, 50 million people will die of antibiotic resistant infections by 2050 based on detailed scenario analyses with KPMG and Rand consultants.

Bacteria are evolutionarily equipt to adapt to stressors such as antibiotics with their capacity to develop and exchange resistance genes through plasmids–small strings of genetic material that supplement DNA. New antibiotics are typically effective for a period of time before bacteria collectively develop resistance traits that hinder the efficacy of said antibiotics. 

Gonorrhea is an antibiotic resistant bacteria that originally responded to the cephalosporin type antibiotics cefixime and ceftriaxone. Resistance to cefixime rose from zero percent to seven percent between 2000 and 2010, and the first case of ceftriaxone-resistant gonorrhea appeared in 2009. This is one example of the many types of bacteria that are developing resistance traits to most if not all of the drugs used to treat the infection. 

“Gonorrhea is doing again what it does so well–and it’s getting ahead of us,” said Dr. Judith Wasserrheit, author and professor at the University of Washington’s Department of Global Health. “What’s changed is that we don't have a drug.”

Pharmaceutical companies have not developed a new class of antibiotics since the 1980s and a lack of novel drugs means that bacteria might eventually develop resistance traits to all antibiotics used to treat them, such as what gonorrhea is doing. 

However, the global COVID-19 pandemic brings awareness to public health–most importantly infectious disease prevention. Handwashing campaigns utilized during the COVID-19 pandemic can be maintained in future years to mitigate the effects of antibiotic resistance by preventing less antibiotic resistant infections in the first place. 

“Handwashing is an important part of the U.S. response to the international emergence of COVID-19,” said Helen Larios, project director at the Joint Commission. “Clean hands are the single-most important factor in preventing the spread of pathogens and antibiotic resistance.”

Pathogens such as COVID-19 viruses and antibiotic resistant bacteria transfer from human to human via two main pathways: airborne particle ingestion or touch contact followed by ingestion. Bacteria latch onto people’s hands when they touch an infected surface. 

Wiping noses, handling food or touching mouths allows bacteria to travel into the body, which is the perfect environment for a pathogenic bacterial infection to develop. Conversely, handwashing removes bacteria from the hands, which effectively cuts off infection development at the source. 

Given we do not have the medicine capable of easily curing antibiotic resistant infections once they develop, preventing a resistant infection from developing in the first place is one way to decrease mortality from bacterial infections. Handwashing is a method of preventing infections that could be emphasized as a means to lessen the prevalence of antibiotic resistant infections given the difficulty of curing a developed resistant infection. 

According to a study from the Journal of Clinical Nursing, the COVID-19 crisis brought about unprecedented amounts of handwashing advertisements and campaigns in the last two years. These included infographics, memes, short videos, billboards and print ads that emphasized the necessity of handwashing to stop the spread of COVID-19. 

Public health officials can maintain this increased level of handwashing advertisements to develop the preventative health measures necessary to keep the number of antibiotic resistant infections at bay.

“Handwashing is the single-most important factor in preventing the spread of pathogens and antibiotic resistance,” Larios said.