Antibiotic resistance coming to Estonia by way of traveling and from Ukraine
Antibiotic resistance is on the rise in poorer countries and conflict zones, a new report shows. In Estonia, cases are brought in by tourists and Ukrainian refugees.
The World Health Organization published its latest report on drug resistance in September. According to Tanel Tenson, professor of antimicrobial compound technology at the University of Tartu, the situation is steadily worsening.
The outlook is particularly bleak in poorer regions like Africa, where, due to climate change, wastewater and drinking water are increasingly mixing. "Climate change doesn't just mean more rain, it also means that when it rains, it pours," Tenson explains. When different water sources mix, the spread of intestinal infections spikes in those regions, he said.
"People always ask how events in Africa could possibly affect us. But how many people actually board planes on this planet every year? Over five billion," he points out. Estonians also travel frequently to Africa, as well as to Southeast Asia and the Arabian Peninsula — all areas with high levels of resistance. "Resistant pathogens from those regions eventually end up here at home," Tenson says.
The war in Ukraine hits even closer to home. On one hand, the country already had a high rate of antibiotic-resistant tuberculosis before the war, which can now spread more easily in shelters. On the other, soldiers are often treated on the front lines in unsanitary conditions. "On the battlefield, dozens or hundreds of wounded soldiers may arrive, needing arms and legs amputated and you're lucky if you can even change the scalpel," the professor illustrates.
Tenson is certain that resistance is reaching Estonia through these channels. "We don't have data collection systems in Estonia that are as advanced as they should be. So if we ask how much resistance is being brought in from Ukraine, unfortunately, the answer is that we just don't know," he admits.
Antibiotic use is governed by the One Health principle, which means that use in humans, animals and agriculture is interconnected. According to Marju Sammul, a specialist at the State Agency of Medicines' pharmacovigilance statistics bureau, Estonia is among the countries using the fewest antibiotics in veterinary care.
The total amount of antibiotics used in animals has steadily declined in Estonia since 2014, she said. At the same time, antibiotics commonly prescribed to humans are still frequently used to treat pets.
According to Sammul, these should not be the first-line treatment in animals. "We have a global traffic-light system: green, yellow and red. The most commonly used drug is classified as green for humans but yellow for animals. So there's a bit of a disconnect in what we're actually using," she notes.
These are only preliminary findings regarding pets. A clearer picture of pet treatment in Estonia will emerge starting in 2029, when the collection of resistance data in companion animals becomes mandatory across Europe.
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Editor: Marcus Turovski
