A multi-drug resistant organism (MDRO) is a bacteria that is resistant to many antibiotics. If bacteria are “resistant” to an antibiotic it means that certain drug treatments will not work.
WHO say ' Antimicrobial resistance (AMR) is resistance of a microorganism to an antimicrobial medicine to which it was originally sensitive. Resistant organisms (they include bacteria, fungi, viruses and some parasites) are able to withstand attack by antimicrobial medicines, such as antibiotics, antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist increasing risk of spread to others."
The evolution of resistant strains is a natural phenomenon that happens when microorganisms are exposed to antimicrobial drugs, and resistant traits can be exchanged between certain types of bacteria. The misuse of antimicrobial medicines accelerates this natural phenomenon. Poor infection control practices encourages the spread of AMR.
Various microorganisms have survived for thousands of years by their ability to adapt to antimicrobial agents. They do so via spontaneous mutation or by DNA transfer. This process enables some bacteria to oppose the action of certain antibiotics, rendering the antibiotics ineffective
Antibiotic resistance is a serious and growing phenomenon in contemporary medicine and has emerged as one of the pre-eminent public health concerns of the 21st century, particularly as it pertains to pathogenic organisms (the term is especially relevant to organisms which cause disease in humans). In the simplest cases, drug-resistant organisms may have acquired resistance to first-line antibiotics, thereby necessitating the use of second-line agents. In the case of some MDR pathogens, resistance to second and even third-line antibiotics is thus sequentially acquired, a case quintessentially illustrated by Staphylococcus aureus in some nosocomial settings. Some pathogens, such as Pseudomonas aeruginosa, also possess a high level of intrinsic resistance.
Tuberculosis is making its grand re-entry in the developed world through MDR Tuberculosis. So countries like India, where anyways tuberculosis is still the grand daddy of all illness, MDR can turn out to be very dangerous.
What precautions should you take at home and in the community?
- An MDRO infection can be picked up in the community by anyone, through skin-to-skin contact or by touching anything that a person carrying the germ has touched.
- Hand hygiene is the most important thing you can do. Wash your hands with a liquid hand soap and water for at least 15 seconds, rubbing all surfaces briskly. Use paper towels to dry hands, and then use the towel to turn off the faucet. Or, use an alcohol hand sanitizer.
- Do not share personal items like towels and washcloths, bars of soap, razors, or clothes.
- Clean bathrooms and launder clothing, bedding, towels, and washcloths regularly.
- Clean objects and surfaces shared with others, such as athletic equipment, before using.
For doctors it is suggested that
- Use the appropriate antimicrobial or antibiotic medicine for an infection; e.g. no antibiotics for viral infections
- Identify the causative organism whenever possible
- Select an antimicrobial which targets the specific organism, rather than relying on a broad-spectrum antimicrobial
- Complete an appropriate duration of antimicrobial treatment (not too short and not too long)
- Use the correct dose for eradication; subtherapeutic dosing is associated with resistance, as demonstrated in food animals.