What is AMR and why does it matter?

1. Prepared by
M’d Saleem
COVAS Mannuthy

2. Introduction
•Antimicrobials resistance
thwarts the treatment of
infectious diseases
worldwide.
•Widespread abuse of
antimicrobials.
•Reduced the availability of
effective antimicrobials
therapies for resistant
infections.

3. WHAT ARE ANTIMICROBIALS?
1. Antibiotic / Antimicrobial
activity against bacteria and
fungi etc.
1. Agents for fighting
bacterial/fungal infections etc.
2. Either kills or Inhibits the
growth of bacteria/fungi etc.
3. Used widely in both human and
veterinary medicine.
“Antibiotics are societal drugs.”

4. • AMR is more commonly observed and studied in bacteria and
fungi. Few parasites have also developed resistance to their
treatment options. If bacteria develop resistance against
“antibiotics”, then it is termed “antibacterial resistance (ABR)”.
If a fungus develops resistance against “antifungals”, then it is
termed “antifungal resistance (AFR)”. Similarly, “antiviral
resistance” and “anthelmintic resistance” is the development
of resistance by viruses and helminths against their treatment
options respectively.

6. Antimicrobial Resistance?
•Antimicrobial
Resistance (AMR)
occurs when bacteria,
viruses, fungi and
parasites change over
time and no longer
respond to medicines
making infections
harder to treat.

7. Antibacterial Resistance (ABR) is the most important among AMR
because many pathogenic bacterial species have developed resistance
leading to serious infections. Resistance in fungi, viruses, and parasites is
minor compared to bacterial resistance, but the report of resistance in
them is also increasing.

8. Effects?

16. Reservoirs in the Ecosystem
•Soil receives numerous ARGs
and antibiotic-resistant
bacteria (ARB) from animal
and human wastes, which
could be subsequently
cycled back to human-
dominated environments.

18. RIVERS
are contaminated with
dangerous levels of antibiotics –
Some 300 times above safe limit’
The drugs find their way into
rivers and soil via human and
animal waste and leaks from
wastewater treatment plants and
drug manufacturing facilities

20. One Health
Antibiotic resistance has become the prominent example of the
importance of the One Health perspective.
Human Health
The Environment
Animal Agriculture

21. Plasmid-mediated mcr-1, resistance to colistin, was first
detected in healthy travelers and an animal source.
(potential dissemination route of ARGs to humans)
Soil fauna grazed on animal manure applied to soil, and their
gut microbiota are likely to be exposed to both antibiotics and
ARGs, which might indirectly impact human health.

23. CONTROL?

24. WHO Global Action Plan
May 2015 World Health Assembly adopted a global
action plan on AMR, which outlines five objectives:

26. India's National Action Plan for AMR
NAP for AMR was released in 17th
April 2017 by the Union Ministry
of Health and Family Welfare.
On the basis of the NAP, various
states have begun the process of
initiating their State Action Plans.

27. Kerala's National Action Plan for AMR
The state of Kerala
became the first Indian
state to launch an
Action Plan. The Kerala
Antimicrobial Resistance
Strategic Action Plan
(KARSAP) was released
on 25th October 2018.

29. The One Health approach is defined as a
joint effort of various disciplines that
come together to provide solutions for
human, animal, and environmental health.
AMR is linked to each of these three
components due to the irresponsible and
excessive use of antimicrobials in various
sectors (agriculture, cattle raising, and
human medicine).