This article appears in the following Journal of Antimicrobial Chemotherapy issue: Tigecycline, a therapeutic option from a new antimicrobial class (the glycylcyclines) in an era of increasing resistance [View the issue table of contents]
Articles |
The growing burden of antimicrobial resistance
1 Division of Immunity and Infection, The Medical School, University of Birmingham, Birmingham B15 2TT, UK 2 Health Protection Agency West Midlands Public Health Laboratory, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK
* Tel: +44-121-424-1240; Fax: +44-121-772-6229; E-mail: peter.hawkey{at}heartofengland.nhs.uk
Since the first usage of antimicrobials, the burden of resistance among bacteria has progressively increased and has accelerated within the last 10 years. Antibiotic resistance genes were present at very low levels prior to the introduction of antibiotics and it is largely the selective pressure of antibiotic use and the resulting exposure of bacteria, not only in humans but also in companion and food animals and the environment, which has caused the rise. The increasing mobility across the globe of people, food and animals is another factor. Examples of this are the international pandemic of different genotypes of CTX-M extended-spectrum β-lactamases (particularly CTX-M-14 and -15) and the emergence of the carbapenemase KPC-1 in both the USA and Israel. This review details examples of both the emergence and dissemination through different genetic routes, both direct and indirect selective pressure, of significance resistance in Staphylococcus aureus, Enterococcus species, Enterobacteriaceae and Pseudomonas/Acinetobacter. The response made by society to reduce resistance involves surveillance, reduced usage, improved infection control and the introduction of new antimicrobial agents. Although efforts are being made in all these areas, there is an urgent need to increase the effectiveness of these interventions or some bacterial infections will become difficult if not impossible to treat reliably.
Keywords: multiresistance , antibiotic development , resistance control
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. van de Beek, E. F. M. Wijdicks, F. H. Vermeij, R. J. de Haan, J. M. Prins, L. Spanjaard, D. W. J. Dippel, and P. J. Nederkoorn Preventive Antibiotics for Infections in Acute Stroke: A Systematic Review and Meta-analysis Arch Neurol, September 1, 2009; 66(9): 1076 - 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Almahmoud, E. Kay, D. Schneider, and M. Maurin Mutational paths towards increased fluoroquinolone resistance in Legionella pneumophila J. Antimicrob. Chemother., August 1, 2009; 64(2): 284 - 293. [Abstract] [Full Text] [PDF]
|
|