Antimicrobial Drug Resistance

The two volumes included in Antimicrobial Drug Resistance, Second Edition is an updated, comprehensive and multidisciplinary reference covering the area of antimicrobial drug resistance in bacteria, fungi, viruses, and parasites from basic science, clinical, and epidemiological perspectives. This newly revised compendium reviews the most current research and development on drug resistance while still providing the information in the accessible format of the first edition. The first volume, Antimicrobial Drug Resistance: Mechanisms of Drug Resistance, is dedicated to the biological basis of drug resistance and effective avenues for drug development. With the emergence of more drug-resistant organisms, the approach to dealing with the drug resistance problem must include the research of different aspects of the mechanisms of bacterial resistance and the dissemination of resistance genes as well as research utilizing new genomic information. These approaches will permit the design of novel strategies to develop new antibiotics and preserve the effectiveness of those currently available. The second volume, Antimicrobial Drug Resistance: Clinical and Epidemiological Aspects, is devoted to the clinical aspects of drug resistance. Although there is evidence that restricted use of a specific antibiotic can be followed by a decrease in drug resistance to that agent, drug resistance control is not easily achieved. Thus, the infectious diseases physician requires input from the clinical microbiologist, antimicrobial stewardship personnel, and infection control specialist to make informed choices for the effective management of various strains of drug-resistant pathogens in individual patients. This 2-volume set is an important reference for students in microbiology, infectious diseases physicians, medical students, basic scientists, drug development researchers, microbiologists, epidemiologists, and public health practitioners.

Does the use of low-dose antibiotics in livestock put human health at risk? Zoonoses—infectious diseases, such as SARS and mad cow, that originate in animals and spread to humans—reveal how intimately animal and human health are linked. Complicating this relationship further, when livestock are given antibiotics to increase growth, it can lead to resistant bacteria. Unfortunately, there are few formal channels for practitioners of human medicine and veterinary medicine to communicate about threats to public health. To address this problem, Dr. Laura H. Kahn and her colleagues are promoting the One Health concept, which seeks to increase communication and collaboration between professionals in human, animal, and environmental health. In One Health and the Politics of Antimicrobial Resistance, Dr. Kahn investigates the use of antibiotics and the surge in antimicrobial resistance in food animals and humans from a One Health perspective. Although the medical community has blamed the problem on agricultural practices, the agricultural community insists that antibiotic resistance is the result of indiscriminate use of antibiotics in human medicine. Dr. Kahn argues that this blame game has fueled the politics of antibiotic resistance and hindered the development of effective policies to address the worsening crisis. Combining painstaking research with unprecedented access to international data, the book analyzes the surprising outcomes of differing policy approaches to antibiotic resistance around the globe. By integrating the perspectives of both medicine and agriculture and exploring the history and science behind the widespread use of growth-promoting antibiotics, One Health and the Politics of Antimicrobial Resistance examines the controversy in a unique way while offering policy recommendations that all sides can accept.

This book presents a thorough and authoritative overview of the multifaceted field of antibiotic science – offering guidance to translate research into tools for prevention, diagnosis, and treatment of infectious diseases. Provides readers with knowledge about the broad field of drug resistance Offers guidance to translate research into tools for prevention, diagnosis, and treatment of infectious diseases Links strategies to analyze microbes to the development of new drugs, socioeconomic impacts to therapeutic strategies, and public policies to antibiotic-resistance-prevention strategies

This ? rst edition of Antimicrobial Drug Resistance grew out of a desire by the editors and authors to have a comprehensive resource of information on antimicrobial drug resistance that encompassed the current information available for bacteria, fungi, protozoa and viruses. We believe that this information will be of value to clinicians, epidemiologists, microbiologists, virologists, parasitologists, public health authorities, medical students and fellows in training. We have endeavored to provide this information in a style which would be accessible to the broad community of persons who are concerned with the impact of drug resistance in our cl- ics and across the broader global communities. Antimicrobial Drug Resistance is divided into Volume 1 which has sections covering a general overview of drug resistance and mechanisms of drug resistance ? rst for classes of drugs and then by individual microbial agents including bacteria, fungi, protozoa and viruses. Volume 2 addresses clinical, epidemiologic and public health aspects of drug resistance along with an overview of the conduct and interpretation of speci? c drug resistance assays. Together, these two volumes offer a comprehensive source of information on drug resistance issues by the experts in each topic.

Years of using, misusing, and overusing antibiotics and other antimicrobial drugs has led to the emergence of multidrug-resistant 'superbugs.' The IOM's Forum on Microbial Threats held a public workshop April 6-7 to discuss the nature and sources of drug-resistant pathogens, the implications for global health, and the strategies to lessen the current and future impact of these superbugs.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.

Antibiotics are powerful drugs that can prevent and treat infections, but they are becoming less effective as a result of drug resistance. Resistance develops because the bacteria that antibiotics target can evolve ways to defend themselves against these drugs. When antibiotics fail, there is very little else to prevent an infection from spreading. Unnecessary use of antibiotics in both humans and animals accelerates the evolution of drug-resistant bacteria, with potentially catastrophic personal and global consequences. Our best defenses against infectious disease could cease to work, surgical procedures would become deadly, and we might return to a world where even small cuts are life-threatening. The problem of drug resistance already kills over one million people across the world every year and has huge economic costs. Without action, this problem will become significantly worse. Following from their work on the Review on Antimicrobial Resistance, William Hall, Anthony McDonnell, and Jim O’Neill outline the major systematic failures that have led to this growing crisis. They also provide a set of solutions to tackle these global issues that governments, industry, and public health specialists can adopt. In addition to personal behavioral modifications, such as better handwashing regimens, Superbugs argues for mounting an offense against this threat through agricultural policy changes, an industrial research stimulus, and other broad-scale economic and social incentives.