What is behind the AMR outbreak in Niger?

Researchers are tracking a worrying rise in antimicrobial resistance - or AMR - in Niger. A new study has shown that poor sanitation, malnutrition and an overburdened healthcare system, has fuelled the spread of a highly resistant form of E.coli in the West African state, and it’s hitting young children the hardest. Experts are also concerned that current war-torn regions, such as Gaza, are also ideal breeding grounds for antimicrobial resistance to flourish. First, let’s hear from Kirsty Sands at Oxford University about what she found has happened in Niger, a country currently in the world’s top ten per cent of countries plagued by antibiotic resistance…

Kirsty - So currently in Niger there are large numbers of children that are severely malnourished. In hospital facilities in Niger, resources are extremely limited, so many children are admitted into quite confined spaces. If these children are exposed to bacteria that may be present in the clinical environment or can be transferred between patients and visitors, there is a greater risk that these children may pick up these bacteria. We previously screened over 6,000 hospital surfaces and in doing so we found a huge diversity of drug-resistant bacteria colonising different surfaces throughout the ward.

Chris - Why, given that's thousands of miles away, do we need to be paying attention?

Kirsty - Of course the burden is highest in environments where there are such limited resources. However, when you look at the global scale, we do see the same bacteria, these same high-risk clones, being found - maybe in smaller numbers - but as we know, people are travelling across the globe. We see bacteria spreading through borders, through people, food, and the environment. And that's why surveillance projects like ours matter. They give us this ability to detect emerging threats and try to understand what the current bacterial landscape is like.

Chris - And is there evidence that when these resistant forms pop up in new geographies, like London for example, they actually cause a problem?

Kirsty - Yes, absolutely. We often consider hospitals as a hotspot and these are places that can fuel the growth and spread of bacteria. And of course, if you are a patient in a hospital in London and you become colonised with a multi-drug-resistant bacteria, you may then go on to become infected with the same bacteria. Because it's drug-resistant, the antibiotics that may be given are likely to be ineffective, may increase length of hospital stay, and just complicate recovery.