Alarm as research shows resistance rising against commonly used antibiotics

The level of resistance to important medicines in the country, especially last line drugs, meaning those needed by patients as a last resort after treatment failure is a major concern among research scientists.

Evidence from several studies presented in a side event at the first day of 12th KEMRI Annual Scientific and Health (KASH) Conference in Nairobi point to a likelihood of people seeking medication turning to the last line drugs, just to survive.

But this is even worrying that resistance has been reported against newly developed antibiotics.

A senior research scientist at KEMRI with professional background in microbiology, Dr. John Mwaniki expressed concern that the current trends in Antimicrobial Resistance (AMR) are worrying.

“Most of the studies presented here today are showing that resistance on the commonly used drugs is on a high trend,” he said.

Mwaniki who was moderating at an AMR session revealed that there is an emerging resistance to last line drugs, those that are being used in the last point of health care.

“This is in terms of a situation where the other antibiotics have failed due to the consistent use of multi drug resistant strains,” he noted.

An example, Mwaniki said is Carbapenem, one of the most effective antibiotics used to treat advanced infections.

Between 30 to 40 percent of all the studies presented, he noted were reporting Multi Drug resistant organisms. “This means that between 15 percent of people with MDR organisms might end up dying,” he said.

He said other studies have also seen resistance to the just recently developed antibiotics.

“One particular case is a presentation of a study trying to analyse a group of drugs called Carbapenem.

So, according to Mwaniki, one of the most interesting things is that this study done in Kilifi, shows that the resistance to Carbapenem was detected. Further taking into account that this particular antibiotics are generally unavailable to the public hospitals, but commonly a preserve of private hospitals, mainly because they are too expensive.

“The question therefore is; how and where are these organisms getting the resistance, yet the main driver of resistance is misuse of antibiotics within communities?” he posed.

He pointed out that there are people using antibiotics as a prophylaxis for diseases in livestock, and others using them over the counter, buying them to self-treat for suspected infection including treating for flus, yet they don’t have flu or virus infection.

Acting KEMRI Director General, Prof. Sam Kariuki said yesterday that recent key sentinel surveillance data in foodborne and the other bacteria in some informal settlements in Nairobi showed that there is an evolution of AMR.

“Combating AMR requires implementation of the National Action Plan, but also through identifying the challenges and gaps that still exist,” he said even as a global report by the World Health Organisation (WHO) in 2019 pointed to a situation where millions of people are dying from drug-resistant infections.

It revealed thattThe AMR is increasingly becoming a serious global public health threat being caused by untreatable infections, prolonged hospital care, most effects will be in the Lower Middle Income Countries (LMICs), desperation over “dry Ab pipeline”.

The report pointed out that AMR will cause a global economic burden on these countries, Kenya included to the tune of USD100 trillion in 2050.

“However, if we implement the Infection Prevention Control (IPC) programmes and hand hygiene in combination with antibiotic stewardship interventions, we are likely to achieve 85 percent reduction in general health burden and two thirds reduction in of AMR infections,” said Prof. Kariuki.

In Kenya although no systematic national surveillance is in place, sentinel studies indicate that AMR is a major public health concern showing that overuse; misuse and counterfeit products are the major contributors.

“Antibiotic use in domestic animals is not well documented, but massive use in intensive small holder and commercial farming systems exists; there is antibiotic overuse in some settings, yet little or no access in others, especially rural and remote places,” he noted.

Antibiotics are used in many settings including clinical medicine, communities, animal husbandry/aquaculture, and horticulture among others.

However, called on the policy makers and researchers to come together to chart the way forward for implementing National Action Plans on AMR and a raft of regulations on over the counter purchase of drugs.

“We have an operational framework on how to control development and spread of AMR. These National Action Plans need to be implemented to the letter in order to cut the cycle in which the transmission is going over and over in many species of organisms,” he said.

If not addressed, the prediction is that an estimated 50 million people will die by the year 2050 due to AMR related infections, and this will even lead to a pandemic.

“Action has to be taken now,” he stated.

Other scientists are also raising the same concerns; resistance is increasing whereas national action plans that guide on the interventions are in force.

A research scientist, Annita Chepkemei weighing in on the matter, said that from the year 2000 to date,there has been a rising trend of resistance to the last line drugs and most importantly to those that have been developed.

“Thus, what we are asking is where is the disconnect?” she posed.

Some of the studies point to a correlation between misuse of antibiotics in animals and their effects on human health. The study shows that raw meat samples obtained from several outlets in Nairobi present with bacterial isolates that exhibit multidrop resistance.

It found considerable contamination of raw meat samples with Klebsiella spp and Listeria leading consumers to the risk of foodborne diseases which have MDR bacteria.

“Before you chew that delicious piece of meat, make sure it’s well cooked and know its source,” she cautioned.

Chepkemei also recommended education on proper meat handling and processing hygiene.

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