21-05-2025
AMR: A ‘silent pandemic' that must be addressed
PETALING JAYA: It started as a simple cough, but in just two weeks, the patient ended up at the Intensive Care Unit (ICU).
'After suffering from coughing for two weeks, my father had a seizure. And the culprit was identified as K. pneumoniae,' said virologist Dr Jasmine E. Khairat. K. pneumoniae is a bacteria with increased resistance to antibiotics.
Dr Jasmine's father had to spend another two weeks in hospital before being able to beat the 'superbug' – or bacteria resistant to drugs.
Some bacteria have grown more resistant to antibiotics, in a situation known as antimicrobial resistance (AMR), making infections harder to treat.
According to the Health Ministry, besides K. pneumoniae, another bacteria known as Escherichia coli (E. coli), which causes wound and urinary tract infections, has also shown increased resistance in Malaysia.
'AMR is a significant threat to public health and the nation's socio-economic well-being,' said Dr Jasmine, the microbiology unit assistant coordinator at the Universiti Malaya (UM) Centre for Natural Product and Drug Discovery.
She said the level of antibiotic resistance varies among superbugs and across different regions and healthcare facilities within Malaysia. 'This is why continuous surveillance is crucial,' she said.
Dr Jasmine said while it is good that Malaysia has plans for AMR, it needs to be continuously tracked and evaluated.
'There should also be more surveillance by expanding systems across human, animal and environmental sectors to track AMR trends and antibiotic usage for informed policy and interventions,' she said.
Unfortunately, granular data is lacking when it comes to AMR in Malaysia, said Universiti Sultan Zainal Abidin's Prof Dr Yeo Chew Chieng, whose expertise includes bacteriology as well as molecular and structural biology.
He said there is a need for better genomic surveillance, which is the process of monitoring pathogens and studying their genetic similarities and differences.
Likening it to knowing the various Covid-19 variants, Prof Yeo said Malaysia needs such information on the various bacteria and their lineages so there can be clearer policies on which antibiotics to prescribe.
'If we don't know the type of bacteria that are causing infections, it will be very difficult to counter this threat.
'We have to do something now if we don't want to face an 'antibiotic apocalypse' (a situation where bacterial infections are untreatable).
'The number of new antibiotics being developed are coming in a trickle, and we need to avoid being outpaced by AMR,' he said.
Prof Yeo said giving livestock antibiotics to prevent diseases and promote growth could be a dangerous practice.
'Many studies have shown that bacteria from livestock and animals could be reservoirs for not only potential bacterial pathogens but also AMR genes,' he said.
UM faculty of science institute of biological sciences senior lecturer Dr Muhamad Afiq Aziz said AMR is like a silent pandemic that demands urgent and collective attention from everyone.
'If we consider the potential impact on global health, the threat posed by AMR is comparable to major diseases like cancer and infectious diseases,' he said.
He called on the government to invest in research and development of alternatives to antibiotics, such as bacteriophages (viruses that target and kill bacteria) and antivirulence agents, which work by disarming bacteria rather than killing them.
'These agents target factors like toxins and enzymes that make bacteria harmful.
'This search for antivirulence compounds is part of my ongoing research sponsored by the Higher Education Ministry.
'We hope it can contribute meaningfully to the broader fight against AMR,' he said.
Dr Muhamad Afiq said each time an antibiotic is used, an environment is created where bacteria that can withstand the drug survive.
'These survivors, often carrying the resistance genes, then multiply and spread.
'If we use fewer antibiotics in general, we give fewer bacteria the chance to develop and pass on resistance,' he said.
Ultimately, Malaysians can also do their part in preventing AMR, said the Health Ministry.
'One of the most effective ways to reduce the need for antimicrobials is by preventing infections before they occur.
'This includes getting vaccinated, practising good personal hygiene and ensuring food is handled and prepared safely,' it said.
