Two Global Health Crises: Is Climate Change contributing to Antimicrobial Resistance?
Global temperatures have increased by about 1ºC in the past century and are continuing to rise. Currently, countries around the world are working towards the targets set out in the Paris Agreement to keep the global temperature rise below 2ºC. The aim is to reduce greenhouse gas emissions as fast as possible. Rising levels of greenhouse gases like carbon dioxide causes high temperatures. These gases act as warming blankets around the Earth, trapping the sun’s energy causing the Earth to warm at a faster rate. Increases in greenhouse gases is almost entirely due to human activity like deforestation which reduces the number of trees absorbing carbon dioxide. It is the rise in earth’s surface temperature causes climate change.
Antimicrobial Resistance(AMR) is a growing public health concern. It occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to drugs designed to kill them, making infections harder to treat and medical procedures much riskier. Antibiotic use in animals also increases the risk of transmitting drug resistant bacteria to humans directly through contact or indirectly through the food chain and environment.
Bacterial resistance can be grouped into:
A. Intrinsic resistance
This is the innate ability of a specific type of bacteria to resist the actions of antibiotics through bacterial structural and functional characteristics. For example, the innate production of enzymes inactivates the drug rendering it ineffective against the bacterium.
B. Acquired resistance
This occurs when a bacterium that used to be sensitive to antibiotics, develops resistance either through mutations or by horizontal gene transfer.
Although antibiotic use has been presumed to be the main force behind the rise of antibiotic resistance, Climate Change could be a contributing factor to antimicrobial resistance.
1. The Link Between AMR and Climate Change
A study led by Derek MacFadden found that rising regional temperatures may contribute to spread of AMR and suggested that higher temperatures might allow faster growth of bacteria or drive increased carriage rates. Bacteria like Staphylococcus aureus thrive in temperatures between 40-140ºF and as temperatures increase, the bacteria reproduce faster increasing transmission. It is also suggested that warmer temperatures may affect the way bacteria respond to certain drug mechanisms. However, further investigation to support this is needed as he added that it was difficult to say exactly what process temperature is affecting.
One suggested mechanism of interaction between rise in temperature and AMR is migration. Animals such as birds or elephants migrate in search of habitat, food or water when subject to warmer temperatures. They may be a source of zoonotic infections and the antimicrobial resistant zoonotic bacteria present can be passed to humans during contact.
Rising ocean temperatures may also force fish to move to cooler waters. The bacterial infections present in fish may be transmitted to humans in the new environment when ingested. Additionally, the overuse of antibiotics in fish food may increase resistance in the antibiotic resistant bacteria.
Precipitation variations and increase in temperature and CO2 has the potential to affect the forage (livestock) as long dry seasons decrease quality and growth of feeds or row crops. This leads to decreased nutrient availability, feed intake and efficiency of feed conversion. Consequently, antibiotics are often given to livestock to promote growth and improve feed conversion efficiency, causing strains of bacteria resistant to antibiotics to be retained and further generated. These bacteria are then passed to other animals or humans.
2. The Burden of AMR
Antimicrobial resistance infections result in at least 700,000 deaths worldwide each year. In the UK, 5,000 people are estimated to die each year. In the EU, antimicrobial resistance causes 25,000 deaths per year. Methicillin-resistant Staphylococcus aureus(MRSA) already cause 80,000 infections and 11,000 deaths annually in the U.S alone.
International agencies report that by 2050, drug-resistant diseases could cause 10 million deaths each year. The rising rates of resistant infections leads to significant impact on cost of treatment. Studies from European Union estimates a cost of 1.5 billion Euros.
Would money to tackle this issue best be spent to help fight climate change, killing two birds with one stone in the process?
3. It Is More Than a Scientific Problem: What Next?
Dame Sally, UK Special Envoy on Antimicrobial Resistance says that the threat of Antimicrobial resistance is as great as that from climate change. Therefore, there is a call for urgent action to prevent the AMR crisis. The Intergovernmental Panel on Climate Change (IPCC) predicts a temperature rise of 2.5 to 10 degrees Fahrenheit over the next century. It is a crisis, there is a need for a system change, it should not be ignored. For the goal of Net zero emission by 2050 to be accomplished, there is a need to avoid burdening the future generations with greater impacts. A 'One Health’ approach; working together in implementation of programs and policies to attain better public health outcomes for humans, animals and their environment. More evidence based research should be done to help inform better policies.
Everyone should take up the responsibility of taking care of the environment by stopping deforestation and adopting renewable energy sources such as solar and wind. There is a need for more use of technologies such Artificial Intelligence that could predict or monitor climate change and AMR or even capture carbon emission in the air but this calls for huge investments. There is a financial gap, investors can help bridge this gap. Different measures also need to be implemented like adopting various action plans for different sectors like in the transport sector: emission can be reduced through supporting public transport or using electric vehicles. All countries should try and build a climate resilient health system that is capable of responding and adapting to climate related issues. However, WHO states that developing countries will be the least able to manage without assistance. Therefore, the high income countries have the moral responsibility to step up and deliver.
Author Information:
Getrude Kayeyia is passionate about personal development. She spends most of her time improving her skills and expanding knowledge. Currently, she is a postgraduate student at the University of Manchester studying medical microbiology and her goal is to venture into policy and advocacy on antimicrobial resistance.
Antimicrobial Resistance(AMR) is a growing public health concern. It occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to drugs designed to kill them, making infections harder to treat and medical procedures much riskier. Antibiotic use in animals also increases the risk of transmitting drug resistant bacteria to humans directly through contact or indirectly through the food chain and environment.
Bacterial resistance can be grouped into:
A. Intrinsic resistance
This is the innate ability of a specific type of bacteria to resist the actions of antibiotics through bacterial structural and functional characteristics. For example, the innate production of enzymes inactivates the drug rendering it ineffective against the bacterium.
B. Acquired resistance
This occurs when a bacterium that used to be sensitive to antibiotics, develops resistance either through mutations or by horizontal gene transfer.
Although antibiotic use has been presumed to be the main force behind the rise of antibiotic resistance, Climate Change could be a contributing factor to antimicrobial resistance.
1. The Link Between AMR and Climate Change
A study led by Derek MacFadden found that rising regional temperatures may contribute to spread of AMR and suggested that higher temperatures might allow faster growth of bacteria or drive increased carriage rates. Bacteria like Staphylococcus aureus thrive in temperatures between 40-140ºF and as temperatures increase, the bacteria reproduce faster increasing transmission. It is also suggested that warmer temperatures may affect the way bacteria respond to certain drug mechanisms. However, further investigation to support this is needed as he added that it was difficult to say exactly what process temperature is affecting.
One suggested mechanism of interaction between rise in temperature and AMR is migration. Animals such as birds or elephants migrate in search of habitat, food or water when subject to warmer temperatures. They may be a source of zoonotic infections and the antimicrobial resistant zoonotic bacteria present can be passed to humans during contact.
Rising ocean temperatures may also force fish to move to cooler waters. The bacterial infections present in fish may be transmitted to humans in the new environment when ingested. Additionally, the overuse of antibiotics in fish food may increase resistance in the antibiotic resistant bacteria.
Precipitation variations and increase in temperature and CO2 has the potential to affect the forage (livestock) as long dry seasons decrease quality and growth of feeds or row crops. This leads to decreased nutrient availability, feed intake and efficiency of feed conversion. Consequently, antibiotics are often given to livestock to promote growth and improve feed conversion efficiency, causing strains of bacteria resistant to antibiotics to be retained and further generated. These bacteria are then passed to other animals or humans.
2. The Burden of AMR
Antimicrobial resistance infections result in at least 700,000 deaths worldwide each year. In the UK, 5,000 people are estimated to die each year. In the EU, antimicrobial resistance causes 25,000 deaths per year. Methicillin-resistant Staphylococcus aureus(MRSA) already cause 80,000 infections and 11,000 deaths annually in the U.S alone.
International agencies report that by 2050, drug-resistant diseases could cause 10 million deaths each year. The rising rates of resistant infections leads to significant impact on cost of treatment. Studies from European Union estimates a cost of 1.5 billion Euros.
Would money to tackle this issue best be spent to help fight climate change, killing two birds with one stone in the process?
3. It Is More Than a Scientific Problem: What Next?
Figure 1. Global Collaboration is required to tackle both AMR and Climate Change.
Dame Sally, UK Special Envoy on Antimicrobial Resistance says that the threat of Antimicrobial resistance is as great as that from climate change. Therefore, there is a call for urgent action to prevent the AMR crisis. The Intergovernmental Panel on Climate Change (IPCC) predicts a temperature rise of 2.5 to 10 degrees Fahrenheit over the next century. It is a crisis, there is a need for a system change, it should not be ignored. For the goal of Net zero emission by 2050 to be accomplished, there is a need to avoid burdening the future generations with greater impacts. A 'One Health’ approach; working together in implementation of programs and policies to attain better public health outcomes for humans, animals and their environment. More evidence based research should be done to help inform better policies.
Everyone should take up the responsibility of taking care of the environment by stopping deforestation and adopting renewable energy sources such as solar and wind. There is a need for more use of technologies such Artificial Intelligence that could predict or monitor climate change and AMR or even capture carbon emission in the air but this calls for huge investments. There is a financial gap, investors can help bridge this gap. Different measures also need to be implemented like adopting various action plans for different sectors like in the transport sector: emission can be reduced through supporting public transport or using electric vehicles. All countries should try and build a climate resilient health system that is capable of responding and adapting to climate related issues. However, WHO states that developing countries will be the least able to manage without assistance. Therefore, the high income countries have the moral responsibility to step up and deliver.
Author Information:
Getrude Kayeyia is passionate about personal development. She spends most of her time improving her skills and expanding knowledge. Currently, she is a postgraduate student at the University of Manchester studying medical microbiology and her goal is to venture into policy and advocacy on antimicrobial resistance.
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| Gertrude Kayeyia (gkayeyia@gmail.com) |
Useful Links & Reference Points
- Antibiotic Resistance Increases with Local Temperature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201249/
- ECDC/EMEA Joint Technical Report: The Bacterial Challenge: Time to React https://ecdc.europa.eu/en/publications-data/ecdcemea-joint-technical-report-bacterial-challenge-time-react
- No Time to Wait: Securing the Future from Drug Resistant Infections: https://www.who.int/antimicrobial-resistance/interagency-coordination-group/final-report/en/
- The Effects of Climate Change: https://climate.nasa.gov/effects/
- World Energy Outlook 2020: https://www.iea.org/reports/world-energy-outlook-2020/achieving-net-zero-emissions-by-2050
Impact of Climate Change on Forage Availability for Livestock: https://link.springer.com/chapter/10.1007%2F978-81-322-2265-1_7
View point: gaps in the current guidelines for the prevention of Methicillin-resistant Staphylococcus aureus surgical site infections: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145096/
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