I was wondering why in developed countries even though the medical facilities and education is better , however, the presence of MDR multi durg resistance and XDR is higher in developed countries compared to some other developing countries?
My second question is why betalactams do not work on Chlamydophyla pneumonia? What makes it special ? And why betalactam is bacteriostatic against Enterococcus?
#antibiotic #Microbiology #resistance #betalactams
As Phil Geis mentions it might be due to the level of use of antibiotics in those regions. However another possibility might be that screening for MDR and XDR is not as prevalent in developing regions so we don't know the actual levels due to insufficient screening for it.
1. It's multifactorial;
- There's no structural health care system i.e. not everybody has access to healthcare (you get sick, self-treat with Abx from the local pharmacy or the private sector) which leads to a late presentation to ER after trying a cocktail of medications (including minimum of 2 Abx).
- Cost of treatment; healthcare is not free for everyone and thus people tend to prioritize basic needs over health (cultural concepts; unless you're dying, no need to see a doctor!) Therefore they'd rather pay for the medications alone than getting a proper consultation and pay its fee too!
- Excellent/fast screening (in the governmental sector).
2. Enterococci are intrinsically resistant to some β-lactam antibiotics such as cephalosporins and carbapenems but resistance to penicillin is acquired either by mutations in penicillin binding proteins (PBPs) or, less frequently, by the production of a β-lactamase.
Hope this helps!
I think microbial strains have being able to aclamatize to the humid environment more than that in less developed countries
One of the main reasons is prolonged/irrational use of antibiotics for treatment. In the past the use of prophylactic antibiotics and in an animal feed as growth enhancers also contributed to MDR
In some underdeveloped countries, access to certain medications, including antibiotics, can only be configured with the presentation of a medical prescription and even so with the specific date to start and finish the treatment, preventive policies are also carried out on the rational use of medication, there are also reasons cultural practices such as the use of medicinal plants commonly used due to their easy access, low cost and empiricism, suggesting these as possible barriers to drug resistance.
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