Resisting Microbial Resistance

When you accidentally cut your finger, odds are that it won’t turn into a life-threatening wound. A century ago, this might have been a concern. The reason minor cuts usually don’t become a serious problem nowadays is that we have access to antibiotic drugs, such as penicillin and amoxicillin. But these miracle drugs are losing their effectiveness – fast.

Antimicrobial resistance is on the rise worldwide. The World Health Organization ranks it among the top 10 biggest threats to global wellness, and without interventions, experts predict that multi-drug resistant microbes will only continue to spread.

“The way we’re using antibiotics right now is destroying them for everyone,” says Mary Wiktorowicz, York University professor of global health governance. But she and her team are working to help preserve effective antimicrobial drugs for future generations.

When most people think of antimicrobial resistance, the first thing that comes to mind is probably drug-resistant bacteria, such as the superbug MRSA. But the term actually encompasses an even wider range of resistances, including drug-proof viruses, fungal infections and parasites.

Micro-organisms usually become resistant to drugs through evolution. Any time a person uses an antimicrobial compound – be it spraying down a surface with Lysol or taking an oral antibiotic to fight an infection – there is a chance that a few genetically predisposed microbes will survive. Once those survivors start to repopulate, all of the microbes descended from them carry the same drug-resistant genes.

This is a huge problem. In addition to preventing superficial wounds from becoming infected, antimicrobials are routinely used to keep livestock healthy, treat diseases such as tuberculosis and pneumonia and prevent infections in people with immune-suppressing conditions. They also allow for modern surgical techniques. If antimicrobials were to stop working completely, the world as we know it would undergo drastic change.

Broadly speaking, Wiktorowicz says, governments have taken two different routes to addressing this issue. The first is regulating antimicrobial use. Many European countries have adopted this approach – for example, by passing laws to limit the use of unnecessary antibiotics in livestock feed. This is in contrast to other nations that are trying to curb antimicrobial resistance by developing new drugs.

“In North America, we seem to have taken the approach that we’re going to innovate our way out of this problem,” says Wiktorowicz, a founding member of the School of Health Policy and Management who, in addition to her work on antimicrobial resistance, has tackled everything from developing global frameworks to monitor zoonotic diseases with pandemic potential to assessing the evolution of mental health policy in Canada.

While such innovation can be useful, she cautions that it doesn’t address the larger structural problems that lead to the rise of drug-resistant microbes in the first place. That’s where Wiktorowicz’s research comes in.

She and her team at York analyze the effectiveness of antimicrobial regulations in countries that have passed them. Then, they determine how similar interventions can be implemented in countries that don’t have them, such as Canada, the U.S. and many parts of the global South. “We’re looking very broadly at the system,” Wiktorowicz says, in hopes of mitigating a crisis. ■