A recent study conducted by researchers from the University of Oxford and Cardiff University has revealed a concerning trend in Nigeria: newborn babies are being born with bacteria that are resistant to colistin, one of the last-resort antibiotics in the world.
This discovery has raised alarm over the use of antibiotics in agricultural settings, which may be contributing to the spread of drug-resistant bacteria.
Sepsis, a life-threatening condition where the body’s immune system overreacts to an infection, is one of the leading causes of death globally, accounting for 11 million deaths annually.
While often associated with adults, sepsis is also a significant threat to newborns, particularly in sub-Saharan Africa, where 2.4 million newborns died from sepsis in 2020 alone. Antibiotics are the primary treatment for sepsis, but the growing issue of antimicrobial resistance (AMR) is making these treatments increasingly ineffective.
AMR occurs when bacteria, fungi, and parasites evolve to resist the effects of medications, rendering standard treatments ineffective. The World Health Organization (WHO) has identified AMR as one of the top global public health threats.
The misuse and overuse of antibiotics in both human medicine and agriculture are major drivers of this resistance. In agriculture, antibiotics are used extensively not only to treat infections in livestock but also to promote faster growth and prevent infections, leading to a rise in resistant strains of bacteria.
The study, which involved the collection of samples from mothers and newborns at three hospitals in Kano and Abuja between 2015 and 2017, is the largest of its kind in Nigeria.
Researchers analysed 4,907 samples in laboratories at Cardiff and Oxford, discovering that 1% of the samples contained genes that confer resistance to colistin. These resistant genes were found in 41 mothers and eight newborns.
What makes these findings particularly concerning is that neither the mothers nor their newborns had been treated with colistin, suggesting that the resistance may have originated from environmental sources.
Colistin is rarely used in hospitals and clinics in Nigeria, which leads researchers to believe that its use in agriculture may be the culprit.
The study hypothesises that mothers may have acquired the resistant bacteria from their environment, which was then passed on to their babies.
The presence of colistin-resistant bacteria in newborns is a grave concern because it indicates that these children may be at a higher risk of developing drug-resistant infections in the future.
Colistin is considered one of the last lines of defense against multidrug-resistant bacteria, and its efficacy is crucial for treating severe infections like pneumonia.
The use of colistin in agriculture, particularly in livestock feed, has been a topic of global concern. In 2016, mobile colistin resistance (mcr) genes were first discovered in E. coli bacteria from a pig farm in China, leading to a ban on colistin use in agriculture in the country.
However, despite bans in Europe and other regions, colistin continues to be used in agricultural settings in low- and middle-income countries like Nigeria, where regulations may be less stringent.
The researchers behind the study are calling for a global ban on the indiscriminate use of colistin in agriculture to preserve its effectiveness in human medicine.
They argue that without such a ban, the world risks accelerating the spread of AMR, leading to more deaths from infections that were once treatable. However, they also acknowledge that a ban could have significant implications for food production and farmers’ livelihoods, particularly in developing countries.
The issue of AMR is not confined to Nigeria. Globally, more antibiotics are prescribed to animals than to humans, with nearly 100,000 tonnes used annually to raise livestock.
This trend is expected to increase by 8% by 2030, potentially leading to a rise in antibiotic-resistant infections.
In response to this growing threat, international efforts are being made to address the misuse of antibiotics in agriculture. For instance, in February 2022, European laws were expanded to make it illegal to use antibiotics in livestock feed as a precautionary measure.
However, there remains a paradox in which European countries, despite these bans, continue to export livestock feeds containing colistin to countries like Nigeria. T
he upcoming UN High-Level meeting on antimicrobial resistance, scheduled for September 2024, presents an opportunity for global leaders to set targets for reducing antibiotic use in farming and to support farmers in improving hygiene practices.
