Topic 13. Antimicrobial Resistance

Antimicrobial Resistance

• Happens when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines

• antibiotics and other treatments become less effective, making infections harder or even impossible to cure

• increases the risk of disease spread, severe illness, disability, and death

genetic changes

Although AMR naturally develops over time due to a.__________________ in microorganisms, its spread is greatly accelerated by human activities—especially the b._____________________ in treating, preventing, or controlling infections in humans, animals, and plants.

a = ?

misuse and overuse of antimicrobials

Although AMR naturally develops over time due to a.__________________ in microorganisms, its spread is greatly accelerated by human activities—especially the b._____________________ in treating, preventing, or controlling infections in humans, animals, and plants.

b = ?

21.36 million

• In 2021, around a.___________ deaths worldwide were linked to b._____, either as the direct cause or as part of the chain of events leading to death.

• Additionally, c.________ people who died that year had drug-resistant infections, including lower respiratory, bloodstream, and intra-abdominal infections.

• Of these, d._____________ deaths were directly attributed to AMR.

• Looking ahead, it is projected that e.__________ people could die due to AMR between 2025 and 2050.

a = ?

sepsis

• In 2021, around a.___________ deaths worldwide were linked to b._____, either as the direct cause or as part of the chain of events leading to death.

• Additionally, c.________ people who died that year had drug-resistant infections, including lower respiratory, bloodstream, and intra-abdominal infections.

• Of these, d._____________ deaths were directly attributed to AMR.

• Looking ahead, it is projected that e.__________ people could die due to AMR between 2025 and 2050.

b = ?

4.71 million

• In 2021, around a.___________ deaths worldwide were linked to b._____, either as the direct cause or as part of the chain of events leading to death.

• Additionally, c.________ people who died that year had drug-resistant infections, including lower respiratory, bloodstream, and intra-abdominal infections.

• Of these, d._____________ deaths were directly attributed to AMR.

• Looking ahead, it is projected that e.__________ people could die due to AMR between 2025 and 2050.

c = ?

1.14 million

• In 2021, around a.___________ deaths worldwide were linked to b._____, either as the direct cause or as part of the chain of events leading to death.

• Additionally, c.________ people who died that year had drug-resistant infections, including lower respiratory, bloodstream, and intra-abdominal infections.

• Of these, d._____________ deaths were directly attributed to AMR.

• Looking ahead, it is projected that e.__________ people could die due to AMR between 2025 and 2050.

d = ?

39 million

• In 2021, around a.___________ deaths worldwide were linked to b._____, either as the direct cause or as part of the chain of events leading to death.

• Additionally, c.________ people who died that year had drug-resistant infections, including lower respiratory, bloodstream, and intra-abdominal infections.

• Of these, d._____________ deaths were directly attributed to AMR.

• Looking ahead, it is projected that e.__________ people could die due to AMR between 2025 and 2050.

e = ?

evolved microorganisms

Causative Agent of AMR

Person-to-person contact

MODE OF TRANSMISSION

1. _______________ during daily activities

2. Through ___________ food, water, and poor hygiene

3. Between ___________ and humans

4. Through _______ (importation of resistant strains)

1 = ?

contaminated

MODE OF TRANSMISSION

1. _______________ during daily activities

2. Through ___________ food, water, and poor hygiene

3. Between ___________ and humans

4. Through _______ (importation of resistant strains)

2 = ?

animals

MODE OF TRANSMISSION

1. _______________ during daily activities

2. Through ___________ food, water, and poor hygiene

3. Between ___________ and humans

4. Through _______ (importation of resistant strains)

3 = ?

travel

MODE OF TRANSMISSION

1. _______________ during daily activities

2. Through ___________ food, water, and poor hygiene

3. Between ___________ and humans

4. Through _______ (importation of resistant strains)

4 = ?

misuse and overuse of antimicrobials

KEY FEATURES

1. AMR can occur naturally but is accelerated by ____________________

2. Resistant infections can spread in both __________________________

3. Some infections become ______________ to treat due to drug resistance

4. Not a single disease, but a __________________ affecting multiple infections

1 = ?

community and healthcare settings

KEY FEATURES

1. AMR can occur naturally but is accelerated by ____________________

2. Resistant infections can spread in both __________________________

3. Some infections become ______________ to treat due to drug resistance

4. Not a single disease, but a __________________ affecting multiple infections

2 = ?

harder or impossible

KEY FEATURES

1. AMR can occur naturally but is accelerated by ____________________

2. Resistant infections can spread in both __________________________

3. Some infections become ______________ to treat due to drug resistance

4. Not a single disease, but a __________________ affecting multiple infections

3 = ?

global health threat

KEY FEATURES

1. AMR can occur naturally but is accelerated by ____________________

2. Resistant infections can spread in both __________________________

3. Some infections become ______________ to treat due to drug resistance

4. Not a single disease, but a __________________ affecting multiple infections

4 = ?

interaction

ENVIRONMENT

1. AMR develops and spreads through the ________ of humans, animals, and the environment.

2. The environment acts as a _______________________________ for resistant microorganisms.

1 = ?

reservoir and transmission pathway

ENVIRONMENT

1. AMR develops and spreads through the ________ of humans, animals, and the environment.

2. The environment acts as a _______________________________ for resistant microorganisms.

2 = ?

Misuse and overuse

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

1 = ?

Poor

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

2 = ?

infection prevention

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

3 = ?

Pollution

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

4 = ?

regulation and lack of enforcement

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

5 = ?

Climate-related

MAJOR CONTRIBUTING ENVIRONMENTAL FACTORS

1. __________________ of antimicrobials in humans and animals

2. ______ sanitation, hygiene, and lack of clean water (WASH)

3. Inadequate ___________________ in healthcare and agriculture

4. ________________ (pharmaceutical waste in soil, water, air)

5. Weak _________________________ of drug policies

6. _______________ factors that enhance microbial spread

6 = ?

Immunocompromised individuals, Elderly and young children, Hospitalized patients, and People with chronic diseases

VULNERABLE POPULATIONS:

• Everyone is at risk, but higher risk in:

vary

SIGNS AND SYMPTOMS

1. ___ depending on infection (e.g., pneumonia, urinary tract infection, sepsis)

2. Key indicator: infections that do not respond to __________________

1 = ?

standard treatment

SIGNS AND SYMPTOMS

1. ___ depending on infection (e.g., pneumonia, urinary tract infection, sepsis)

2. Key indicator: infections that do not respond to __________________

2 = ?

Prolonged

COMPLICATIONS:

1. ____________ illness

2. Increased risk of ________________

3. Higher _________________

4. longer _____________

1 = ?

severe disease or death

COMPLICATIONS:

1. ____________ illness

2. Increased risk of ________________

3. Higher _________________

4. longer _____________

2 = ?

healthcare costs

COMPLICATIONS:

1. ____________ illness

2. Increased risk of ________________

3. Higher _________________

4. longer _____________

3 = ?

hospital stays

COMPLICATIONS:

1. ____________ illness

2. Increased risk of ________________

3. Higher _________________

4. longer _____________

4 = ?

Laboratory Testing

Diagnosis

alternative or stronger antimicrobials

TREATMENT:

1. Use of _________________________________ (if available)

2. Increasing difficulty due to _____________________

1 = ?

limited effective drugs

TREATMENT:

1. Use of _________________________________ (if available)

2. Increasing difficulty due to _____________________

2 = ?

antibiotics

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

1 = ?

hygiene and sanitation

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

2 = ?

Vaccination

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

3 = ?

Infection

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

4 = ?

awareness and education

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

5 = ?

policies and surveillance systems

PREVENTION

1. Proper use of _____________ (only when prescribed)

2. Improved _______________________

3. ________________

4. ________ prevention and control practices

5. Public ________________________

6. Strengthening ___________________________

6 = ?

Philippine National Action Plan on AMR (PNAP) 2024-2028

GOVERNMENT PROGRAMS:

• Provides a national framework to combat antimicrobial resistance, aiming to reduce its burden through a One Health approach

• focuses on policy, surveillance, stewardship, and awareness, serving as the country’s main roadmap for coordinated, multi-sectoral efforts nationwide

Antimicrobial Resistance Surveillance Program (ARSP)

GOVERNMENT PROGRAMS:

• Monitors resistance trends to guide treatment and policy decisions

• focuses on laboratory-based pathogen surveillance and is important for enabling evidence-based

Antimicrobial Stewardship Program (AMS)

GOVERNMENT PROGRAMS:

• promotes the rational use of antibiotics to reduce misuse and resistance

• focuses on prescription monitoring and adherence to guidelines, improving patient safety and treatment outcomes across hospitals nationwide.

Antimicrobial Use Point Prevalence Study (AMU-PSS)

GOVERNMENT PROGRAMS:

• Assesses antibiotic usage patterns to improve stewardship strategies

• focuses on tracking hospital antibiotic use and is important for identifying inappropriate prescribing in selected hospitals nationwide.

Philippine Antimicrobial Resistance Awareness Week (PAAW)

GOVERNMENT PROGRAMS:

• Raises awareness about AMR and promotes responsible antibiotic use

• focuses on public education campaigns and encourages behavior change through a nationwide annual campaign.

Global Tricycle Surveillance Project

NON-GOVERNMENT PROGRAMS

• Monitors AMR across sectors to strengthen integrated surveillance

• focuses on E. coli in humans, animals, and the environment, supporting a One Health approach, with a global scope that includes the Philippines.

1Health Project

NON-GOVERNMENT PROGRAMS

• Conducts research on antimicrobial resistance to improve interventions and inform policies

• examines the links between humans, animals, and the environment

• importance lies in promoting innovation and interdisciplinary solutions, with a scope that includes research institutions and communities.

World Health Organization (WHO) AMR Initiatives

NON-GOVERNMENT PROGRAMS

• Support antimicrobial resistance programs worldwide, aiming to align countries with the global strategy

• focus on providing technical guidance, funding, and standards, strengthening both national and global responses to AMR, with a scope that includes support for the Philippines.

Hospital-Based Antimicrobial Stewardship Programs in Private and Academic Hospitals

NON-GOVERNMENT PROGRAMS

• Aim to implement local antibiotic control to improve prescribing practices

• focus on audits, infection control, and staff training, reinforcing frontline AMR efforts within individual hospitals and institutions.

financial toll

CURRENT ISSUES AND CHALLENGES

1. The _________________ is massive: the World Bank projects up to $1 trillion in additional healthcare costs by 2050 and annual global GDP losses reaching $3.4 trillion by 2030.

2. Modern medicine is falling behind the curve of resistance. Success depends on ________________________________________________ of treatments and diagnostics.

3. While AMR is a universal threat, it disproportionately affects _______________ countries, where poverty and inequality amplify both its causes and its deadly effects.

1 = ?

revitalizing research and securing a global, equitable supply

CURRENT ISSUES AND CHALLENGES

1. The _________________ is massive: the World Bank projects up to $1 trillion in additional healthcare costs by 2050 and annual global GDP losses reaching $3.4 trillion by 2030.

2. Modern medicine is falling behind the curve of resistance. Success depends on ________________________________________________ of treatments and diagnostics.

3. While AMR is a universal threat, it disproportionately affects _______________ countries, where poverty and inequality amplify both its causes and its deadly effects.

2 = ?

low- and middle-income

CURRENT ISSUES AND CHALLENGES

1. The _________________ is massive: the World Bank projects up to $1 trillion in additional healthcare costs by 2050 and annual global GDP losses reaching $3.4 trillion by 2030.

2. Modern medicine is falling behind the curve of resistance. Success depends on ________________________________________________ of treatments and diagnostics.

3. While AMR is a universal threat, it disproportionately affects _______________ countries, where poverty and inequality amplify both its causes and its deadly effects.

3 = ?