Antimicrobial resistance in the context of Antibiotic

Conversations regarding the ethics of eating meat are focused on whether or not it is moral to eat non-human animals. People who abstain from eating meat are generally known as "vegetarians" and people who avoid all animal by-products are known as “vegans”. They avoid meat for a variety of reasons, including taste preference, animal welfare, ethical reasons, religion, the environmental impact of meat production (environmental vegetarianism), health considerations, and antimicrobial resistance. Individuals who promote meat consumption do so for a number of reasons, such as health, cultural traditions, religious beliefs, and scientific arguments that support the practice. The majority of the world’s health and dietetics associations state that a well-planned vegetarian or vegan diet can be nutritionally adequate for all stages of life.

A common argument used in the animal rights movement is the argument from marginal cases, asserting that non-human animals should have the moral status similar to that of marginal case human beings such as human infants, the senile, the comatose, and the cognitively disabled. Proponents argue that there are no morally relevant traits that these marginal humans possess that animals lack.

An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth (bacteriostatic agent). Antimicrobial medicines can be grouped according to the microorganisms they are used to treat. For example, antibiotics are used against bacteria, and antifungals are used against fungi. They can also be classified according to their function. Antimicrobial medicines to treat infection are known as antimicrobial chemotherapy, while antimicrobial drugs are used to prevent infection, which known as antimicrobial prophylaxis.

The main classes of antimicrobial agents are disinfectants (non-selective agents, such as bleach), which kill a wide range of microbes on surfaces to prevent the spread of illness, antiseptics which are applied to living tissue and help reduce infection during surgery, and antibiotics which destroy microorganisms within the body. The term antibiotic originally described only those formulations derived from living microorganisms but is now also applied to synthetic agents, such as sulfonamides or fluoroquinolones. Though the term used to be restricted to antibacterials, its context has broadened to include all antimicrobials. In response, further advancements in antimicrobial technologies have resulted in solutions that can go beyond simply inhibiting microbial growth. Instead, certain types of porous media have been developed to kill microbes on contact. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens. It is estimated that bacterial antimicrobial resistance (AMR) was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.

Antiparasitics are a class of medications which are indicated for the treatment of parasitic diseases, such as those caused by helminths, amoeba, ectoparasites, parasitic fungi, and protozoa, among others. Antiparasitics target the parasitic agents of the infections by destroying them or inhibiting their growth; they are usually effective against a limited number of parasites within a particular class. Antiparasitics are one of the antimicrobial drugs which include antibiotics that target bacteria, and antifungals that target fungi. They may be administered orally, intravenously or topically. Overuse or misuse of antiparasitics can lead to the development of antimicrobial resistance.

Broad-spectrum antiparasitics, analogous to broad-spectrum antibiotics for bacteria, are antiparasitic drugs with efficacy in treating a wide range of parasitic infections caused by parasites from different classes.

An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. Such drugs are usually obtained by a doctor's prescription, but a few are available over the counter (OTC). The evolution of antifungal resistance is a growing threat to health globally.

Mobile genetic elements (MGEs), sometimes called selfish genetic elements, are a type of genetic material that can move around within a genome, or that can be transferred from one species or replicon to another. MGEs are found in all organisms. In humans, approximately 50% of the genome are thought to be MGEs. MGEs play a distinct role in evolution. Gene duplication events can also happen through the mechanism of MGEs. MGEs can also cause mutations in protein coding regions, which alters the protein functions. These mechanisms can also rearrange genes in the host genome generating variation. These mechanisms can increase fitness by gaining new or additional functions. An example of MGEs in evolutionary context are that virulence factors and antibiotic resistance genes of MGEs can be transported to share genetic code with neighboring bacteria. However, MGEs can also decrease fitness by introducing disease-causing alleles or mutations. The set of MGEs in an organism is called a mobilome, which is composed of a large number of plasmids, transposons and viruses.

Triclosan (sometimes abbreviated as TCS) is an antibacterial and antifungal agent present in some consumer products, including toothpaste, soaps, detergents, toys, and surgical cleaning treatments. It is similar in its uses and mechanism of action to triclocarban. Its efficacy as an antimicrobial agent, the risk of antimicrobial resistance, and its possible role in disrupted hormonal development remains controversial. Additional research seeks to understand its potential effects on organisms and environmental health.

Triclosan was developed in 1966. A 2006 study recommended showering with 2% triclosan as a regimen in surgical units to rid patients' skin of methicillin-resistant Staphylococcus aureus (MRSA).

Vaccine resistance is the evolutionary adaptation of pathogens to infect and spread through vaccinated individuals, analogous to antimicrobial resistance. It concerns both human and animal vaccines. Although the emergence of a number of vaccine resistant pathogens has been well documented, this phenomenon is nevertheless much more rare and less of a concern than antimicrobial resistance.

Vaccine resistance may be considered a special case of immune evasion, from the immunity conferred by the vaccine. Since the immunity conferred by a vaccine may be different from that induced by infection by the pathogen, the immune evasion may also be easier (in case of an inefficient vaccine) or more difficult (would be the case of the universal flu vaccine). We speak of vaccine resistance only if the immune evasion is a result of evolutionary adaptation of the pathogen (and not a feature of the pathogen that it had before any evolutionary adaptation to the vaccine) and the adaptation is driven by the selective pressure induced by the vaccine (this would not be the case of an immune evasion that is the result of genetic drift that would be present even without vaccinating the population).

An opportunistic infection is an infection that occurs most commonly in individuals with an immunodeficiency disorder and acts more severely on those with a weakened immune system. These types of infections are considered serious and can be caused by a variety of pathogens including viruses, bacteria, fungi, and parasites. Under normal conditions, such as in humans with uncompromised immune systems, an opportunistic infection would be less likely to cause significant harm and would typically result in a mild infection or no effect at all. These opportunistic infections can stem from a variety of sources, such as a weakened immune system (caused by human immunodeficiency virus and acquired immunodeficiency syndrome), when being treated with immunosuppressive drugs (as in cancer treatment), when a microbiome is altered (such as a disruption in gut microbiota), or when integumentary barriers are breached (as in penetrating trauma). Opportunistic infections can contribute to antimicrobial resistance in an individual making these infections more severe. Some pathogens that cause these infections possess intrinsic resistance (natural resistance) to many antibiotics while others acquire resistance over time through mutations or horizontal gene transfer. Many of these pathogens, such as the bacterium Clostridioides difficile (C. diff), can be present in hosts with uncompromised immune systems without generating any symptoms, and can, in some cases, act as commensals until the balance of the immune system is disrupted. With C. diff and many other pathogens, the overuse or misuse of antibiotics can cause the disruption of normal microbiota and lead to an opportunistic infection caused by antibiotic resistant pathogens. In some cases, opportunistic infections can be labeled as a hospital-acquired infection due to individuals contracting them within a healthcare/hospital setting. In terms of history, there is not one individual that can be attributed for discovering opportunistic infections. Over time and through medical advancement, there have been many scientists that have contributed to the study and treatment options for patients affected by these infections.

A broad-spectrum antibiotic is an antibiotic that acts on the two major bacterial groups, Gram-positive and Gram-negative, or any antibiotic that acts against a wide range of disease-causing bacteria. These medications are used when a bacterial infection is suspected but the group of bacteria is unknown (also called empiric therapy) or when infection with multiple groups of bacteria is suspected. This is in contrast to a narrow-spectrum antibiotic, which is effective against only a specific group of bacteria. Although powerful, broad-spectrum antibiotics pose specific risks, particularly the disruption of native, normal bacteria and the development of antimicrobial resistance. An example of a commonly used broad-spectrum antibiotic is ampicillin.

β-Lactam antibiotics (beta-lactam antibiotics) are antibiotics that contain a β-lactam ring in their chemicalstructure. This includes penicillin derivatives (penams), cephalosporins and cephamycins (cephems), monobactams, carbapenems and carbacephems. Most β-lactam antibiotics work by inhibiting cell wall biosynthesis in the bacterial organism and are the most widely used group of antibiotics. Until 2003, when measured by sales, more than half of all commercially available antibiotics in use were β-lactam compounds. The first β-lactam antibiotic discovered, penicillin, was isolated from a strain of Penicillium rubens (named as Penicillium notatum at the time).

Bacteria often develop resistance to β-lactam antibiotics by synthesizing a β-lactamase, an enzyme that attacks the β-lactam ring. To overcome this resistance, β-lactam antibiotics can be given with β-lactamase inhibitors such as clavulanic acid.