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“We are experiencing a crisis in antimicrobial resistance that many people don't know much about,” according to Robin Patel, M.D., an infectious diseases physician, medical microbiologist, and director of the Infectious Diseases Research Laboratory at Mayo Clinic.
A study in The Lancet looked at the year 2019 and estimated that there were five million deaths globally associated with bacterial antimicrobial resistance that year. “Projections that go out to 2050, tell us that globally, 10 million people will die every year due to antimicrobial resistance unless we do something differently than we're doing today,” she shares.
“In my opinion, antimicrobial resistance is not completely stoppable. We're not going to cure this problem, because we need to use antibiotics. That's why it's a challenge.”
The more we use antibiotics, the more we put pressure on bacteria to develop resistance to them. “What we need to do is figure out (in the US and globally) how to address this ever-changing situation,” Dr. Patel says. “For many people who have infections with drug-resistant bacteria, that infection is not the first problem they have. They might have cancer, for example, or they might be undergoing a transplant or surgery. And then, they develop a complicating infection.”
In the past, they would receive an antibiotic to treat that infection and it would clear it right up. But today, because of resistance, that's not always the case. “We also see people who do not start off having the problem of infection with an antimicrobial-resistant bacterium but end up with that and get very sick and even die from it. These scenarios are what's projected to get worse,” she says.
Adding to the complexity of the issue is that bacteria are all around us and in us. “They are in the environment – in our food, on our pets, and in and on our plants. We can't see bacteria except by using a microscope. Disease-causing bacteria also cross borders without any policing since they may come in on people or goods.” That said, Dr. Patel reminds us that not all bacteria are bad and that we have many ‘good bacteria’, which are part of our microbiome and important for human health.
“We are not going to solve antimicrobial resistance,” she says. “We need to learn how to live with it.”
Dr. Patel serves on the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria. The council provides advice, information, and recommendations to the U.S. Secretary of Health and Human Services on fighting antimicrobial resistance (AMR) in human, animal, and environmental health. Council members have expertise from various backgrounds, including academia, industry, public health, advocacy, veterinary, and agricultural production. She is also a former president of the American Society for Microbiology.