(R2075) Genesis of Antibiotic Resistance LXIV: Mechanism(s) of Attenuation of Antibiotic Resistant Bacterial Pathogen(s) (ARBP) virulence augmented by Social Engineering - Break the chain of transmission of Infection
At present, the pathophysiological basis and its sequelae of antibiotic resistant bacterial pathogens induced infectious diseases (ARBID) pandemic and manageable preventive strategies are not well understood. Here we present the results from the investigation analyzing the data on the role of social distancing (SD by Shelter in / Stay home) and Contact Tracing(CT). The objective of SD/CT is to break the chain of transmission of ARBP infection by finding that infected person, identify their contacts and advise them to quarantine at home while educating them about breaking the chain of transmission of infection to mitigate the spread of infection by ARBID. According to the “Global Microbial Resistance Surveillance System,” data on antimicrobial resistance report, eight priority bacterial pathogens in humans namely: 󠄠i. Escherichia coli, ii. Klebsiella pneumonia, iii. Acinetobacter spp., iv. Staphylococcus aureus, v. Streptococcus pneumonia, vi. Salmonella spp, vii. Shigella spp, viii. Neisseria gonorrhoeae detected in blood, urine, stool, and genital swabs of patient samples are considered the greatest threat across the globe. Based on the continuum of pandemic phases and surveillance components presented in WHO/CDC report on “Global Influenza Programme,” we have extrapolated to ARP as a. interpandemic phase during which new ARBID could be detected in animals but not in humans possibly emerging low risk of human cases / high risk of human cases; b. the pandemic alert phase where detection of human cases with a possibility of increased evidence of human to human transmission of ARBID and c. pandemic phase where an increased, efficient, and sustained human to human transmission is reported as morbidity & mortality rate. According to 2019 AR Threats Report, classified as a. urgent threats, b. serious threats, and c. concerning threats, of which more than 2.8 million antibiotic-resistant infections occur in the U.S. To demonstrate the conceptual basis of SD/CT mediated attenuation, we have chosen ARBID considered as an urgent threat. The practice of social distancing by Staying six feet apart only congregate and small Gatherings when absolutely necessary would likely to bring the R zero value to a minimum reflected in the ability of an infected individual to transmit infection. Concurrently implementing CT, If the reproductive number for ARBID is between 2 and 3 so each person with this infection on average passes it along to two to three other people. By robust CT, essentially to bring the reproductive number down below one, averaging each person infected with the ARBP, infects fewer than one other person and that's when we can manage the pandemic effectively because we don't have that ongoing spread and exponential growth . We suggest that effective SD/CT would likely to alter the following microbial growth parameters such as temperature: a. Decimal reduction time (DRT or D value), b. Thermal death time (TDT) and c. Thermal death point (TDP). Taken together, an altered D, TDT, and TDP reflecting on R= zero value possibly by regression of exponential growth relieving the selection pressure causing deamplification of ARGR.