How do global migration and the mixing of people affect antimicrobial resistance?

AMR is here and will prolong its stay if we don't take steps to curb it. With the Pandemic, Antimicrobial Resistance sharpened its claws by breeding in the shadows. Invisible to the public eye, antimicrobial resistance (AMR) exacts a measurable cost on patients and their loved ones by spreading resistant germs that result in life-threatening complications and even premature death.

The increased observed burden of AMR may be attributable, in part, to the widespread increase in antibiotic use and the availability of non-prescription antibiotics around the world.

Firstly, antibiotic resistance is a multifaceted problem affected by several variables, including the type of bacteria, individual patient factors, diet, immunization, socioeconomic determinants of health, and antibiotic exposures. The impact of antibiotic-resistant bacteria is evident in hospitals and the community. Still, laboratory antibiotic resistance gets tested in vitro using technical guidelines usually determined through consensus.

This distinction is vital when considering the impact of antibiotic resistancess, as the clinical repercussions of infections produced by resistant bacteria get misunderstood as the laboratory-focused, microbiological definition of antibiotic resistance.

In transit and host countries, migrants get subjected to environments that can develop medication resistance. There is a pressing need to improve living conditions. We must see that they get access to health care and the initiative to facilitate detection. Appropriately high-quality treatment is a must for antibiotic-resistant infections among refugees and asylum seekers, as well as in high-migrant community settings. All migrant populations should have ready access to healthcare services that focus on preventing and controlling infections and monitoring antibiotic resistance before, during, and after their journeys.

There is growing concern that increased migration is adding to the burden of antibiotic resistance in e world, mainly in Europe, where rates of AMR are among the highest in the world. There is less information on the prevalence of AMR bacterial strains among migrants. It suggests that refugees from the Syrian crisis are susceptible to pathogens due to their crowded living conditions and a lack of access to clean water and sanitation in both conflict zones and European host countries. Precarious conditions, such as those experienced in host nations, make migrants especially susceptible to AMR. However, migrants do not constitute a threat to local people.

We can do various things to help the newly arrived migrants with their health care requirements. People may have fallen ill or been exposed to AMR during the journey to the nation, increasing the urgency with which they must get treated. We underline the importance of authorities being able to convince newly arriving migrants that health assessments are conducted immediately, kept confidential, and have no influence on their eligibility for the right to stay.

While there is some literature on screening for AMR at entry crossings into host countries, there are cases of infection management upon arrival among migrants. (Refer Sources). However, a review of the available research argues that mandatory AMR screening of migrants should be implemented as an initial preventative step. (Refer Sources) The focus of infectious disease screening among migrants should be on creating sustainable techniques to make screening more accessible and increase treatment (Refer Sources). Due to ethical concerns and the possibility that those most at risk might try to evade medical attention, the benefits of implementing mandatory screening alone are doubtful.

In conclusion, health fairness and early access to healthcare are critical issues for migrants. If antimicrobial resistance (AMR) is not addressed in healthcare facilities, the healthcare system will be less likely to achieve its goal of optimal health for all its constituents. Migrants and other marginalized populations need better living conditions and healthcare access for their well-being and to minimize the spread of future AMR strains that could cause much more widespread damage to society.

Sources

• Dara M, Sulis G, Centis R, D'Ambrosio L, De Vries G, Douglas P, et al. Cross-border collaboration for improved tuberculosis prevention and care: policies, tools and experiences. Int J Tuberc Lung Dis. (2017) 21:727–36. doi: 10.5588/ijtld.16.0940
• Seedat F, Hargreaves S, Nellums LB, Ouyang J, Brown M, Friedland JS. How effective are approaches to migrant screening for infectious diseases in Europe? A systematic review. Lancet Infect Dis. (2018) 18: e259–71. doi: 10.1016/S1473-3099(18)30117-8