Antimicrobial resistance(AMR) has drawn worldwide attention due to its increasing threat towards the global health. The term, antimicrobial resistance is to describe the ability of various types of microorganisms, for instances parasites, viruses, bacteria and fungi, in neutralizing the effect of antimicrobials which is either to kill them or to inhibit their growth. As a result, it becomes harder to treat most of common infections which used to be cured easily. It also delays the completion of treatment, increasing the duration of illness thus eventually increases the overall cost of health care (WHO, 2016).
Because microbes have the innate capability to resist against the destructive or suppressive effect of antimicrobials, it is possible to develop antimicrobial resistance each time of usage. The resistant strains of microbes are in everywhere. They can be found in animals, humans and even in environment such as soil, water and air. It can also be found in foods. There are multiple routes of transmission ; from humans who have the resistant strains to another humans, from animals to humans, and from environment to humans. For example, the most common way of animal-to-human transmission would be through consumption of meats. If the contaminated meat by resistant strains is consumed without proper process or being cooked, the drug-resistant microbes will propagate to human (WHO, 2016).
In Malaysia, the National Surveillance on Antibiotic Resistance Report has shown an escalation of methicillin-resistant Staphylococcus aureus (MRSA) from 17.2% in 2014 to 19.3% in 2015. As for Escherichia coli, although the percentage of ciprofloxacin-resistant strains of E. coli remained fairly stable from 2013 to 2015, which is approximately 23.7% in 2015, its resistance to ampicillin has surged from 66.2% in 2014 to 67% in 2015 (“NSAR - Institute for Medical Research, Malaysia,” 2015).
Numerous factors could contribute to the development of antimicrobial resistance. Overuse of antimicrobials, especially antibiotics, is one of dominant factors. Antibiotics are commonly taken even for viral infections like flu or cold even though they are not suitable agents to treat such infections. Studies have also shown that antibiotics are overly prescribed worldwide. In the husbandry or agricultural sector, antibiotics is used as a growth promoter of crops. With these, the spread of antimicrobial resistance is accelerating (Ventola, 2015; WHO, 2016).
Inappropriate use of antimicrobials, for instance cessation of administration without finishing the complete course of antimicrobial treatment or administration of antimicrobials below its therapeutic doses, is also a main countributing factor of the antimicrobial resistance development (WHO, 2016).
In addition to overuse and misuse of antimicrobials, inadequate infection control or poor hygiene could also engage in the emergence and the spread of resistance.
Therefore, development of resistance can decrease by diminishing the number and amount of antimicrobials use. In order to cut down the use, we should firstly prevent the infection beforehands. Vaccination, safe food-handling and handwashing can reduce the chances of infection and prevent the dissemination of resistant microbes at the same time (WHO, 2016).
To successfully tackle this issue, the World Health Assembly has come up with a global action plan in May 2015. Meanwhile the Malaysian government has adopted several measures to contain and combat antimicrobial resistance. The National Surveillance of Antimicrobial Resistance Programme (NSAR) has been established since 1997 in government hospitals to keep track on the emergence and transmission of drug-resistant bacteria. Malaysian hospitals have been performing regular scrutiny on antibiotics use to reduce the misuse. Also there is the Infection and Antibiotic Control Committees in every hospital to devise and apply algorithms and guidelines of antibiotic therapy in clinical settings (Arumugam, 2016; WHO, 2015).