Emergence of Antimicrobial Resistance is Much Greater in Low- than High-Income Countries

This recent article in Science [1] gives five evidence-based reasons for greater emergence of, and more devastating consequences from, antibiotic resistance in low-income countries (LICs) compared to higher income countries:

1. LICs harbour a higher rate of extremely virulent organisms, such as those responsible for typhoid fever and tuberculosis.
2. Antimicrobials are (even) less carefully regulated and are frequently available ‘over the counter’.
3. Treatment for established infection is more often delayed and access to supportive care for life-threatening infections is less widely available.
4. Laboratory testing for the infectious agent is less widely available and therefore ‘syndromal’ treatment based on suspicion, rather than confirmation of a bacterial cause for ill health, is understandably widespread.
5. Routine dosing of animals to improve yields is more widespread.

Of course, increasing resistance to antibiotics in LICs impacts on high-income countries, and the article shows how molecular tracking of microbial genetics has enabled the dissemination of resistance genes to be mapped across the world.

The CLAHRC WM Director thinks that new molecular genetic techniques will help target antibiotics at the correct diagnosis, and also help in controlling the spread of resistant organisms. The technology is becoming ever cheaper, as discussed in a previous blog.

— Richard Lilford, CLAHRC WM Director

Reference:

1. Baker S. A return to the pre-antimicrobial era? Science. 2015; 347(6226):1064-6.