Food Safety and Drug-Resistant Infections

During World Antimicrobial Awareness Week, I met Nuru*, a high school student in Kenya who participated in an antimicrobial resistance awareness campaign I organized. For Nuru, there was a personal motivation to help bring awareness to antimicrobial resistance (AMR). Nuru had suffered from bacterial food poisoning after eating ‘mutura’ an organ meat sausage that is a common local street food. Hoping to find relief, she bought over-the-counter antibiotics and painkillers from a local chemist. However, these medications didn’t help, and her condition worsened rapidly.

Nuru’s parents took her to a nearby hospital where they learned that the antibiotics needed to treat her were not available. To afford the medication, they sold a goat, an important part of their livelihood, so that they wouldn’t lose their daughter. After several days in the hospital, Nuru finally received the appropriate antibiotics and began to recover. Her experience made her a passionate advocate for responsible antibiotic use and raising awareness about the antimicrobial resistance crisis. Antimicrobial resistance or AMR occurs when bacteria, viruses, fungi, and parasites evolve to resist drugs used to treat infections they cause—this results in longer illnesses, higher treatment costs, and higher mortality rates.

Nuru’s story serves as a reminder of the devastating impact of antimicrobial resistance and the need for education and action to combat this issue that can affect everyone. It also shows AMR’s connection to food safety and nutrition.

Many factors related to food safety greatly impact the emergence and spread of AMR. Consuming unsafe food increases the risk of developing food-borne illnesses, including those caused by drug-resistant microbes. In low-and middle-income countries, research shows that large quantities of antimicrobials are used to treat food-borne diseases. Additionally, antibiotics are often given to animals to promote growth and prevent disease, leading to the development of antibiotic-resistant bacteria in animals, which can then be transmitted to humans through the handling and consumption of contaminated food. The use of antifungals in crop production can also lead to the spread of antifungal-resistant fungal pathogens in the environment.

To complete the requirements for my dietetics degree at Jomo Kenyatta University of Agriculture and Technology in Kenya, I was a clinical nutrition intern. During my rotation, I encountered Nala*. The one-year-old girl was hospitalized with cholera, an acute bacterial infection mostly acquired and spread through contaminated food and water. Nala’s story sadly reveals many challenges faced by families in low-income countries in preventing, treating, and surviving infections.

To begin with, Nala’s primary caregiver in the ward was her 12-year-old sister. After some inquiries, I discovered their mother was also admitted to the adult medical ward with the same condition. Adding to their difficulties, Nala’s father was away in the countryside planning for the burial of her stepmother, who had tragically passed away from the same illness the previous week.

Nala’s family faced many hardships in addition to battling this illness. They dealt with financial burdens and the risk of malnutrition because they simply could not cope with all the expenses. They worried about the accumulating medical bills and their limited financial resources. Additionally, Nala was underweight and possibly malnourished.

The situation lived by Nala reveals the profound impact that food-borne illnesses caused by poor food safety have on entire families, particularly in low-income countries. But things could have been worse if the bacteria causing cholera had been resistant to treatment.

This narrative reveals the urgent need to address food safety issues and improve access to healthcare resources in low-income countries. It also underscores the potentially devastating consequences of antimicrobial resistance in the treatment of food-borne illnesses.

Nutrition and food-related sectors have a responsibility to promote sustainable and responsible food production practices, including reducing the use of antibiotics in livestock and preventing infections from happening in the first place by improving hygiene practices and using available vaccines. By promoting healthy and sustainable food systems, we can contribute to families living healthy lives and reduce the emergence and spread of AMR. Public policy and initiatives to combat AMR must include access to sufficient, safe, and nutritionally rich foods to improve immunity and overall well-being.

Improving access to nutritious food, ensuring food safety, and mitigating the use of antimicrobials in agriculture are vital in the fight to control AMR. Together, we can make a difference and help protect future generations by ensuring we have the tools to fight infections.

(*Names changed to maintain anonymity.)

Image from Shutterstock

Edited by Samantha Serrano