Antimicrobial Resistance

Organizations fighting against antimicrobial resistance

This world-wide problem has been taken very seriously by national and international organizations. WHO states (e.g., 1998 and 2002) that “WHO is working to develop and implement a global strategy for the containment of antimicrobial resistance”.

The following is a transcript from http://www.niaid.nih.gov/factsheets/antimicro.htm on antimicrobial resistance from the National Institute of Allergy and Infectious Diseases and NIH.
Antimicrobial Resistance

Drug-resistant infectious agents – those that are not killed or inhibited by antimicrobial compounds – are an increasingly important public health concern. Antimicrobial resistance is becoming a factor in virtually all hospital-acquired (nosocomial) infections. Many physicians are concerned that several bacterial infections soon may be untreatable.

In addition to its adverse effect on public health, antimicrobial resistance contributes to higher health care costs. Treating resistant infections often requires the use of more expensive or more toxic drugs and can result in longer hospital stays for infected patients. The Institute of Medicine, a part of the National Academy of Sciences, has estimated that the annual cost of treating antibiotic resistant infections in the United States may be as high as $30 billion.

A key factor in the development of antimicrobial resistance is the ability of infectious organisms to adapt quickly to new environmental conditions. Microbes generally are unicellular creatures that, compared with multicellular organisms, have a small number of genes. Even a single random gene mutation can have a large impact on their disease-causing properties; and since most microbes replicate very rapidly, they can evolve rapidly. Thus, a mutation that helps a microbe survive in the presence of an antibiotic drug will quickly become predominant throughout the microbial population. Microbes also commonly acquire genes, including those encoding for resistance, by direct transfer from members of their own species or from unrelated microbes.

The innate adaptability of microbes is complemented by the widespread and sometimes inappropriate use of antimicrobials. Ideal conditions for the emergence of drug-resistant microbes result when drugs are prescribed for the common cold and other conditions for which they are not indicated or when individuals do not complete their prescribed treatment regimen. Hospitals also provide a fertile environment for drug-resistant pathogens. Close contact among sick patients and extensive use of antimicrobials force pathogens to develop resistance.