QCOSTARICA — Costa Rica is currently one of the countries with the highest bacterial resistance in the world, a situation that is shared throughout the Latin American region and is not new.
The biggest cause of this bacterial resistance according to Jose Molina, a microbiologist at the University of Costa Rica (UCR), is the misuse of antibiotics. These abuses cause bacteria to evolve and learn to live in different environments that were previously lethal to them.
The three bacteria that the World Health Organization (WHO) considers a priority are Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae. These have in common resistance to the antibiotic called Carbapenem and have been reported in the country for more than a decade.
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People who are hospitalized are those who are most exposed to these bacteria and, because their immune system is weaker, these organisms take advantage of the situation and can be lethal for patients.
Why does bacterial resistance occur?
Molina points out that this evolution in bacteria is strongly associated with the abuse of antibiotics that occurs in Costa Rica, understanding this as an incorrect use of medications when treating different diseases.
A very common scenario is when unused antibiotics are used, in some cases these drugs are used to combat non-bacterial infections, such as a virus or a fungus. This situation trains bacteria to become resistant, according to Molina.
Another recurring situation in which antibiotics are used incorrectly is when people end their treatment early because they feel better. This causes the bacteria that did resist the antibiotic and were not eliminated to reproduce and adapt to living with the drug.
“In countries where there is great abuse of antibiotic use, these resistance mechanisms are much more frequent and much more difficult to eradicate,” Molina commented.
Doctors have problems treating patients, according to Molina. Since there are no antibiotics that have an effect against these bacteria due to the resistance they have been generating and there is no way to cure them.
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“This is not something new, what is happening is that it is becoming more and more worrying. Now the treatments that were considered before are supposed to not be resistant,” added the microbiologist.
Defense mechanisms
Faced with all this, it is important to understand the defense mechanisms of bacteria, since they not only developed resistance to antibiotics but also to disinfectants, so medical personnel must take special care when dealing with these patients.
According to Molina, bacteria have been mutating and thus developing new techniques to survive antibiotics. One of them is to directly destroy the chemical structure of the medications, so they stop working.
Another example of a defense mechanism that these organisms have is that they learn to hide their vulnerable areas. Certain antibiotics are focused on a specific point on the bacteria, so they hide these areas so that they can survive and the medications have no effect.
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“What the bacteria basically occupies is a strategy to survive something with which we are attacking it. This is not necessarily designed to kill us, but this is a fact that as an agent it produces disease, which we try to combat,” Molina added.
It is important to remember that bacteria reproduce in millions, unlike humans, which reproduce one at a time. Therefore, there are more possibilities for them to mutate and the mutations that survive are the ones that are maintained.
This is an evolution at a rate much greater than what humans can control, which is why constant progress in antibiotics is needed, according to the UCR microbiologist.
Necessary measures
Molina highlights the importance of medical centers and their hygiene practices, referring to the need for nurses to be careful when dealing with infected patients, because they can spread the bacteria throughout different rooms and affect others.
He also pointed out the importance of doing tests in laboratories to prescribe antibiotics for certain bacteria. “Although in some cases the statistics indicate that a drug is appropriate, you still have to be careful,” he added.
“Medical settings have the responsibility of providing a therapeutic option that is realistic for the infection and that will only be resolved with a laboratory test depending on the case,” Molina commented.
Translated and adapted from the article “Mal uso de antibióticos coloca a Costa Rica entre países con bacterias más resistentes del mundo” published at SemanarioUniversidad.com.
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