By Chijioke Iremeka
Senior medical and nutrition experts say malnutrition could lead to antibiotic resistance.
They also noted that malnutrition could make antibiotics ineffective in treating infections.
The professors spoke against the backdrop of findings of a new study, which suggested that micronutrient deficiencies in humans could cause antibiotic resistance, thereby increasing the global burden of antimicrobial resistance.
According to the World Health Organisation, antimicrobial resistance is one of the top global public health and development threats.
Researchers from the Faculty of Medicine, University of British Columbia Children’s Hospital Research Institute, led by a postdoctoral researcher, Dr. Paula Littlejohn, said they found connections between micronutrient deficiencies and antibiotic resistance.
The team, in a study published in Nature Microbiology recently, claimed that the composition of gut microbiomes in early life could explain why resistance to antibiotics has been rising across the globe.
Titled ‘Multiple micronutrient deficiencies in early life cause multi-kingdom alterations in the gut microbiome and intrinsic antibiotic resistance genes in mice,’ the team investigated how deficiencies in crucial micronutrients such as vitamin A, B12, folate, iron, and zinc affected the community of bacteria, viruses and fungi among other microbes that live in the digestive system.
“This is a significant discovery, as it suggests that nutrient deficiencies can make the gut environment more conducive to the development of antibiotic resistance, which is a major global health concern,” the Lead researcher, Littlejohn, declared.
Speaking in an exclusive interview with Reportr Door Healthwise, a Professor of Clinical Microbiology at the Benue State University, Godwin Jombo also affirmed that malnutrition can cause antibiotic resistance in humans.
Jombo explained, “When there is malnutrition, the micronutrients such as zinc, copper and other trace elements are reduced. These nutrients are useful in bodybuilding and the immune system. When they are not there, it becomes difficult for them to fight the bacteria.
“Remember that they help build enzymes and tissues in the body including the cells of the immune system that fight invading microorganisms. So when there is malnutrition, the body’s defence system is affected and cannot fight the diseases.
“So, while you are giving medications, the body is not responding and the bacteria are getting used to the antibiotics, leading to resistance. It is not the antibiotics that take diseases out of the body; antibiotics stop the rapid multiplication of the bacteria to allow the body to deal with them. So, malnutrition makes it difficult for the body to fight diseases.”
On the right medicine to use for treatment of infections in malnourished persons to avoid resistance and for effectiveness, he said, “When an undernourished child has an infection, it becomes an issue.
“If such a child is brought to the hospital and the child’s life is at risk, we will commence broad-spectrum antibiotics while we send the child’s blood sample to the laboratory for a test.
“When we isolate the organisms and carry out the anti-microbial sensitivity test. The result will tell us the class of antibiotics to use in treating the child.
“It is the test that will tell us whether to continue with the drugs initially prescribed by the doctor or use the ones that the organisms are susceptible to.”
He added that when there is malnutrition, the cellular function is low and if antibiotics are taken, it will not flush out the bacteria because the immune system is low.
On his part, a Professor of Human Nutrition and Vice-Chancellor of Ave Maria University, Abuja, Ignatius Onimawo, said malnutrition makes antibiotics ineffective and not resistant.
He argued that malnutrition cannot cause antibiotic resistance, saying, “If you say that antibiotics will not be effective, it is better than say resistance.
” Malnutrition cannot cause resistance to antibiotics, but a child that is malnourished will not be able to respond positively to treatment because antibiotics will not be effective.”
The don stated that the only connection between malnutrition and infection is that malnutrition lowers the body’s immune system.
Onimawo said, “Malnutrition reduces the body’s defence line so that the body won’t be able to fight diseases. So, it is strange to say that malnutrition causes antibiotic resistance.
“The only connection between malnutrition and infection is that malnutrition lowers the body’s immune system, whether adult or children, so that it cannot fight diseases that enter the body.
“But if you are poorly nourished and your immune system breaks down, that is the idea behind the Vitamin A supplementation during immunisation.
Before now, they had been giving polio vaccines to children until they discovered that it wasn’t effective. Then Vitamin A was brought in because they noticed that most children were deficient in Vitamin A.”
Continuing, he said, “Then, the body of the children could not fight the polio virus and other viruses that cause illnesses. So, when they introduced vitamin A augmentation, they found out that there was an increase in the ability of the body to fight the infection.
“So it made the vaccine work better and made the person resistant to the polio virus and diseases. But for malnutrition to lead to antibiotic resistance is strange to me.”
The WHO’s latest data estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.
Although Nigeria does not have comprehensive data on AMR, experts say antibiotic abuse, overdose and misuse account for the burden of antibiotic resistance in the country.
The National Action Plan for Antimicrobial Resistance, 2017-2022, found that bad use of antibiotics was common with 42 per cent of adults 46.7 per cent to 71.1 per cent of five years’ children being given antibiotics without a prescription, and 68.3 per cent of adults using antibiotics following the prescription.
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