Resistance to Antibiotics is on the Rise
Drug-resistant Pathogens: Notorious Globe-trotters!
Drug resistance is spreading worldwide. Hospitals and other healthcare settings are engaged in a battle against drug-resistant organisms that disseminate within these institutions – but resistant strains also spread in the community at large. Global travels transfer drug resistant organisms between continents at jet speed. The growth of medical tourism has accelerated the international spread of hospital-acquired infections that are frequently resistant to multiple drugs. In addition, the food chain is considered as an additional pathway for the dissemination of resistant strains.
“We are losing our first-line antimicrobials.”
Dr. Margaret Chan, director general of the World Health Organization (March 2012)
Hospitals are a critical component of the antimicrobial resistance problem worldwide. They have become hotbeds for highly-resistant pathogens such as MRSA (Methicillin-resistant Staphylococcus aureus), ESBL (Enterobacteria producing Extended-Spectrum Beta-Lactamases) or CRE (Carbapenem-Resistant Enterobacteriaceae), increasing the risks of resistant nosocomial (hospital-acquired) and opportunist infections. When multi-resistant, the pathogens are very expensive to control, extremely difficult to eradicate and sometimes resistant to all available antimicrobial agents (see the next section on the Burden of resistance).
Escherichia coli: proportion of invasive isolates with resistance to fluoroquinolones
The doctors have to deal with the growing need to turn to second and third-line antibiotics as first line anti-bacterial drugs are increasingly inefficient. Many specialists are concerned about the possible overuse of the more powerful antibiotics as first-line therapies. Several resistance surveillance networks have been set up to monitor the rise of resistance - their periodic conclusions are alarming: the resistance is on the rise.
Acinetobacter baumannii: prevalence of resistance to imipenems
As bacteria are able to pick up and exchange resistance genes, some bacteria end up with a collection of resistance genes targeting several classes of antibiotics. These multi-drug resistant strains are able to withstand the actions of a large number of (if not all) antibiotics. They lead to therapeutic impasse: clinicians receive lab report in which every single drug is listed as resistant. This is major blooming public health crisis!
Combined resistance of E.coli to aminopenicillins, 3rd generation of cephalosporins, aminoglycosides and fluoroquinolones
“Multidrug-resistant bacteria represent a major threat to the success of almost all branches of medical practice” EMA-ECDC, The Bacterial Challenge report (Sep 2009)