Mycobacterial Diseases
Open Access

Managing Antimicrobial Resistance and Preserving Gut Balance

Abrea Scany^{* *}Correspondence: Abrea Scany, Department of Infectious Disease, Seoul National University, Seoul, South Korea, Email:

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Description

Antimicrobial Resistance (AMR) is an escalating global health concern. It refers to the ability of bacteria, viruses, fungi, and parasites to resist the effects of medications that once effectively treated infections. While the emergence of AMR is well-known in hospital settings, less attention is paid to how this phenomenon plays out in the human gut. The gut microbiome, a diverse community of microorganisms residing in our digestive tract plays an essential role in human health, contributing to digestion, immune system regulation, and even the production of essential vitamins. Understanding how AMR develops in the gut, without disturbing the delicate balance of this microbiome, is important to maintaining overall health. The human gut microbiome is home to trillions of microorganisms, including bacteria, archaea, viruses, and fungi. These microbes coexist in a symbiotic relationship with the host (i.e., humans). A healthy gut microbiome is characterized by high microbial diversity, which provides numerous benefits, such as better digestion, enhanced immune function, and protection against harmful pathogens. However, the overuse or misuse of antibiotics poses a significant threat to this balance. When antibiotics are introduced into the body, they not only target harmful bacteria but also disrupt beneficial bacteria in the gut. This indiscriminate killing of microbes can lead to a less diverse microbiome, which is linked to various health issues such as obesity, inflammatory bowel disease, and even mental health disorders. Moreover, the frequent use of antibiotics promotes the survival of antibioticresistant bacteria, leading to AMR.

Developing of gut microbiome in AMR

Antibiotics are designed to eliminate bacterial infections, but their use can also encourage the development of resistant bacteria within the gut. As antibiotics destroy susceptible bacteria, they inadvertently create a competitive advantage for resistant strains. These resistant bacteria can multiply and eventually dominate the microbiome. Over time, this leads to the accumulation of resistance genes within the gut's microbial population. Moreover, resistant bacteria in the gut can share their resistance traits with other bacteria through horizontal gene transfer, exacerbating the problem. The gut microbiome, therefore, becomes a reservoir for resistant bacteria, which can potentially transfer these genes to pathogens that can cause infections. This makes the treatment of infections more challenging and poses a significant risk to public health.

Balancing of microbiome and AMR

The challenge lies in managing AMR without compromising the beneficial bacteria within the gut. Here are some key strategies to achieve this balance:

Judicious use of antibiotics: One of the most effective ways to combat AMR is by reducing the overuse of antibiotics. Antibiotics should only be prescribed when necessary, and broad-spectrum antibiotics (which target a wide range of bacteria) should be avoided unless absolutely needed. Narrowspectrum antibiotics that target specific pathogens are less likely to disrupt the diversity of the gut microbiome.

Use of probiotics and prebiotics: Probiotics, which are live beneficial bacteria, and prebiotics, which are fibers that promote the growth of healthy bacteria, can help maintain gut diversity during and after antibiotic treatment. Research shows that certain probiotic strains can prevent the overgrowth of resistant bacteria by occupying ecological niches in the gut. Prebiotics, on the other hand, can nourish beneficial bacteria, helping them thrive despite antibiotic intervention.

Alternatives to antibiotics: In some cases, non-antibiotic therapies may be used to treat infections or prevent the growth of harmful bacteria. Phage therapy, for example, uses viruses that specifically target bacterial cells, leaving the rest of the microbiome unharmed. Antimicrobial peptides and immunotherapies are also being explored as alternative treatments that can reduce the reliance on traditional antibiotics and thus prevent the development of AMR.

Fecal Microbiota Transplantation (FMT): FMT involves transplanting gut bacteria from a healthy donor into a recipient with a disrupted microbiome. This procedure has been successful in treating conditions like Clostridioides difficile infections, which often develop following antibiotic use. By restoring a healthy balance of gut bacteria, FMT may also help reduce the spread of antibiotic resistance in the gut.

Diet and lifestyle: A diverse and fiber-rich diet can promote a healthy gut microbiome. Whole grains, fruits, vegetables, and fermented foods like yogurt and kimchi can foster a balanced microbial community, reducing the risk of overgrowth by resistant strains. Regular exercise and stress management also contribute to a healthy gut environment, which supports microbial diversity and resilience.

Conclusion

Antimicrobial resistance in the gut is a serious concern, but it is possible to address it without disrupting microbiome diversity.

Through the careful use of antibiotics, the incorporation of probiotics and prebiotics, exploration of alternative therapies, and lifestyle modifications, we can protect the gut microbiome while also reducing the spread of AMR. By preserving the natural balance of microorganisms in the gut, we can maintain overall health and mitigate the risks posed by antibiotic resistance.