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Combatting Antimicrobial Resistance in a Changing Climate

Written by Medix Biochemica | Jul 11, 2024 8:00:00 AM

Climate change and antimicrobial resistance (AMR) are two of the biggest global health challenges facing our world today.1 We’re discovering that the two problems are closely linked, highlighting the need for an effective approach towards addressing them both. 

 

The link between climate change and AMR

The state of AMR

AMR occurs when microbes (bacteria, viruses, fungi and/or parasites) stop responding to antimicrobial medicines. This makes infectious diseases more difficult or even impossible to treat, increasing the risk of disease spread, severe illness and death.2 

In 2019, AMR was directly responsible for 1.27 million global deaths and contributed to a further 4.95 million deaths.2 It’s forecast to cause 10 million global deaths per year by 2050.3 

The main driving factor behind AMR is the misuse and overuse of antimicrobials in humans, animals and plants.2,3,4 Scientists are still developing an understanding of how other contributing factors, like climate change, spread and exacerbate the problem of AMR.4

The state of climate change

Climate change affects the health of people, animals and ecosystems1 – every organism living on this planet. The World Health Organization (WHO) describes climate change as the biggest health threat facing humanity, forecasting 250,000 additional deaths per year as a result of climate change between 2030 and 2050.4 

It’s believed that the current climate crisis is making AMR worse, although the link between the two issues is still being examined.4 Here’s what we know:

 

How do rising temperatures affect the spread of disease?

Many diseases are climate-sensitive,  e.g. changes in temperature and other environmental conditions can lead to an increase in water-borne diseases and a higher risk of food- and vector-borne diseases.1,4 The rising temperatures caused by climate change are associated with increased bacterial growth rates and horizontal gene transfer, which also links them to the spread of AMR.4

Climate change causes geographical changes in the concentration and spread of certain diseases too. For example, vector-borne infections from tropical climates, such as Zika, dengue and chikungunya, have started migrating to other countries because of the warming temperatures.4

Climate change is also causing the geographical territory for some vectors to spread.5 Certain vectors need a specific range of temperatures to survive, and now the ideal temperature range for these vectors is available across other regions.5 This means tropical pathogens are spreading out closer to the poles, and some vectors are becoming active at higher altitudes as the temperatures rise.5 Higher temperatures are also linked to shorter incubation periods.5

Diseases are now spreading to new, non-endemic countries as a result of changing weather patterns (rising temperatures).5 For example, France saw a record high in cases of dengue in 2022 following intense heatwaves.5

Table 1: Examples of how climate change has created favorable conditions for the spread of infectious diseases like cholera and malaria4

Microorganisms Impact of climate change Outcome (disease)
Campylobacter spp. and
Salmonella spp.
Rising temperatures in the water system create more favorable conditions for microorganism survival Water- and food-borne
diseases
Vibrio cholerae Rising temperatures lead to natural disasters, creating more favorable conditions for microorganism survival Cholera (water-borne)
Candida auris Gained tolerance to heat and salinity in the
wetland ecosystem 
Candidiasis (fungal infection)
Plasmodium falciparum Rising temperatures and humidity make transmission easier Malaria (vector-borne)

Outbreaks of infectious diseases as the result of climate change are therefore likely to lead to the increased use of antimicrobial treatments in humans, animals and plants.4 And if these treatments are not used correctly, the microbes will become resistant.2

 

How do extreme weather events (natural disasters) contribute to AMR?

Climate change causes extreme weather events like floods and hurricanes,6 which can exacerbate AMR in several ways:1

  • Population displacement increases the spread of infectious diseases and places pressure on healthcare systems.
  • Overcrowding and lack of sanitation among displaced populations increases the spread of disease and rates of AMR.
  • Disrupted access to health services can lead to an increase in preventable infectious diseases and an associated increase in the use of antimicrobial medicines.
  • Damage to wastewater and sewage infrastructure increases the risks of flooding, floodwater pollution, sewage overflow and agricultural runoff, spreading antimicrobial-resistant organisms through the waterways and soil.
AMR and water pollutants: Antimicrobial-resistant bacteria and antibiotic-resistance genes (ARGs) are not completely removed during wastewater treatment. Wastewater therefore acts as a reservoir for ARGs, which have been identified as emerging pollutants in soil and water. Microplastic pollutants have also been proposed as hotspots of horizontal gene transfer in water sources.4

Read more about natural disasters and infectious diseases.

 

Combating AMR: What are the challenges and what role does IVD play?

Misdiagnosing a viral infection as bacterial usually means the patient is given unnecessary antibiotics, which increases the risk of AMR.7 It follows that improving the diagnostic distinction between viral and bacterial infections can help to reduce overuse of antibiotics and decrease that risk.7 

In vitro diagnostics (IVD) plays a critical role here, helping healthcare professionals to differentiate between different diseases that present with similar symptoms.7

Read more about enabling better infection differentiation.

Point-of-care (PoC) IVD testing is the ideal solution for resource-limited situations,8,9 in which testers may often have limited access to rapid and accurate diagnosis methods, leading to misdiagnosis and overtreatment. This is especially relevant following a natural disaster.7  POC IVD testing can be done at or near the site of patient care, using mobile equipment, making accurate diagnoses and monitoring more accessible.8,9 In this way, IVD helps to improve disease management in challenging settings.

Accurate diagnosis of virus = no unnecessary use of antibiotics = better management of AMR

 

Medix Biochemica’s IVD solutions 

Who are Medix Biochemica? Medix Biochemica is a provider of high-quality antibodies, antigens, proteins and enzymes for the development of IVD assays. Our portfolio is among the most comprehensive in the IVD industry, enabling our customers to develop and manufacture a wide range of quality IVD tests.10

How do we respond to evolving IVD customer needs? Our strategic position in the value chain allows us to respond swiftly to market needs and supply chain challenges.

How do we support our customers through the buyer journey? We prioritize a customer-centric approach, with transparent communication, ISO certifications and regulatory support, tailored product offerings, and after-sales support. We offer suggested antibody pairs and technical assistance to help our clients create products of the highest quality, accuracy and reliability.

Do we offer raw materials for IVD infectious disease tests? Yes, our comprehensive portfolio includes products for a wide variety of infectious disease tests. Our recent acquisition of ViroStat, a leader in infectious-disease antibodies and antigens, has allowed us to enhance our product portfolio and manufacturing capabilities.11

Strategies for the future

There are several improvements that can be made on a global, national and local level to combat the spread of AMR:12

  • Better infection control and prevention measures
  • Rational use of antimicrobial medications
  • A ban on over-the-counter antimicrobials
  • Antimicrobial stewardship and surveillance programs
  • Better education for patients around the use of antimicrobials

From governments and international agencies to hospitals, pharmacies and individual patients, collaboration and participation on all levels is needed to curb the spread of AMR. Ultimately, prevention and accurate diagnosis are the best ways to reduce the spread of infectious diseases and thereby AMR.12

Similarly, adopting a One Health approach could help to address interconnected health and environmental challenges.13

“One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent.”
– World Health Organization13

Read more about One Health.

As a leading global IVD raw-material supplier, Medix Biochemica is proud to be a link in the chain of effectively diagnosing and treating infectious diseases.

Curious about how our products can help you to enhance your IVD offering?

References:

1. Antimicrobial resistance and the climate crisis. Global Leaders Group on Antimicrobial Resistance. Accessed June 4, 2024. https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-gcp-tjs/amr-and-the-climate-crisis.pdf?sfvrsn=6d7c7a5b_7.
2. Antimicrobial resistance. World Health Organization. Accessed June 4, 2024. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.
3. Tang KWK, Millar BC, Moore JE. Antimicrobial resistance (AMR). Br J Biomed Sci. 2023;80:11387. doi:10.3389/bjbs.2023.11387.
4. Magnano San Lio R, Favara G, Maugeri A, et al. How antimicrobial resistance is linked to climate change: An overview of two intertwined global challenges. Int J Environ Res Public Health. 2023;20(3):1681. doi:10.3390/ijerph20031681.
5. Paz S. Climate change: A driver of increasing vector-borne disease transmission in non-endemic areas. PLOS Medicine. 2024;21(4):e1004382. doi:10.1371/journal.pmed.1004382.
6. Anderson J, Bausch C. Climate change and natural disasters: Scientific evidence of a possible relation between recent natural disasters and climate change. Policy brief for the EP Environment Committee IP/A/ENVI/FWC/2005-35.
7. Expert opinion. Interview with Gerben Zuiderveld, Sr. Global Product Manager, Medix Biochemica. March 2023. 
8. Tran NK, Godwin Z, Bockhold J. Point-of-care testing at the disaster-emergency-critical care interface. Point Care. 2012;11(4):180. doi:10.1097/POC.0b013e318265f7d9.
9. Chen H, Liu K, Li Z, et al. Point of care testing for infectious diseases. Clin Chim Acta. 2019;493:138-147. doi:10.1016/j.cca.2019.03.008.
10. Enabling better infection differentiation: Using inflammation marker panels to determine bacterial vs viral origin. Medix Biochemica. Accessed June 4, 2024. https://24933742.fs1.hubspotusercontent-eu1.net/hubfs/24933742/Webinars/Sept%202023_Sepsis/Slide%20deck%20-%20Sept%202023%20Sepsis%20webinar.pdf.
11. Medix Biochemica acquires ViroStat. Medix Biochemica. Accessed June 5, 2024. https://articles.medixbiochemica.com/medix-biochemica-acquires-virostat.
12. Uchil RR, Kohli GS, Katekhaye VM, et al. Strategies to combat antimicrobial resistance. J Clin Diagn Res. 2014;8(7):ME01-ME04. doi:10.7860/JCDR/2014/8925.4529.
13. One Health. World Health Organization. Accessed June 5, 2024. https://www.who.int/health-topics/one-health.