Surveying Antimicrobial Resistance Approaches Issues And Challenges To Overcome

Why Antibiotic Resistance? The use of antibiotics in human and veterinary medicine may have consequences beyond their intended applications. The “One Health” concept recognizes that the health of humans is connected to the health of animals and the environment. Progress in molecular genetics is facilitating the rapid evaluation of the essentiality of these targets on a genomic scale. In 2015, a group of researchers established the International Conference on Antibiotic Resistance (IC2AR).The primary objective of this meeting is to bring together scientists involved in antibiotic resistance prevention and control. The IC2AR conducted its inaugural world congress in January 2015 at Caparica (Portugal). Antimicrobial resistance presents a significant challenge to scientists in the field of infectious diseases. The full knowledge of how antibiotics resistance is evolving and being transmitted between hosts in different ecosystems is taking on great importance. Necessary action includes research to define the scope of the problem including its various sources. This eBook comprises a series of original research and review articles dealing with the epidemiology of resistance in animal and zoonotic pathogens, mobile elements containing resistance genes, the omics of antimicrobial resistance, emerging antimicrobial resistance mechanisms, control of resistant infections, establishing antimicrobial use and resistance surveillance systems, and alternatives strategies to overcome the problem of antimicrobial resistance worldwide. Gilberto Igrejas, José Luis Capelo and Patrícia Poeta Scientific Committee of IC2AR, February 20th, 2017

Why Antibiotic Resistance? The use of antibiotics in human and veterinary medicine may have consequences beyond their intended applications. The "One Health" concept recognizes that the health of humans is connected to the health of animals and the environment. Progress in molecular genetics is facilitating the rapid evaluation of the essentiality of these targets on a genomic scale. In 2015, a group of researchers established the International Conference on Antibiotic Resistance (IC2AR).The primary objective of this meeting is to bring together scientists involved in antibiotic resistance prevention and control. The IC2AR conducted its inaugural world congress in January 2015 at Caparica (Portugal). Antimicrobial resistance presents a significant challenge to scientists in the field of infectious diseases. The full knowledge of how antibiotics resistance is evolving and being transmitted between hosts in different ecosystems is taking on great importance. Necessary action includes research to define the scope of the problem including its various sources. This eBook comprises a series of original research and review articles dealing with the epidemiology of resistance in animal and zoonotic pathogens, mobile elements containing resistance genes, the omics of antimicrobial resistance, emerging antimicrobial resistance mechanisms, control of resistant infections, establishing antimicrobial use and resistance surveillance systems, and alternatives strategies to overcome the problem of antimicrobial resistance worldwide. Gilberto Igrejas, José Luis Capelo and Patrícia Poeta Scientific Committee of IC2AR, February 20th, 2017Why Antibiotic Resistance? The use of antibiotics in human and veterinary medicine may have consequences beyond their intended applications. The "One Health" concept recognizes that the health of humans is connected to the health of animals and the environment. Progress in molecular genetics is facilitating the rapid evaluation of the essentiality of these targets on a genomic scale. In 2015, a group of researchers established the International Conference on Antibiotic Resistance (IC2AR).The primary objective of this meeting is to bring together scientists involved in antibiotic resistance prevention and control. The IC2AR conducted its inaugural world congress in January 2015 at Caparica (Portugal). Antimicrobial resistance presents a significant challenge to scientists in the field of infectious diseases. The full knowledge of how antibiotics resistance is evolving and being transmitted between hosts in different ecosystems is taking on great importance. Necessary action includes research to define the scope of the problem including its various sources. This eBook comprises a series of original research and review articles dealing with the epidemiology of resistance in animal and zoonotic pathogens, mobile elements containing resistance genes, the omics of antimicrobial resistance, emerging antimicrobial resistance mechanisms, control of resistant infections, establishing antimicrobial use and resistance surveillance systems, and alternatives strategies to overcome the problem of antimicrobial resistance worldwide. Gilberto Igrejas, José Luis Capelo and Patrícia Poeta Scientific Committee of IC2AR, February 20th, 2017.

In January of 2015, under the 1st International Caparica Conference in Antibiotic Resistance, a Research Topic entitled: “Surveying Antimicrobial Resistance: Approaches, Issues, and Challenges to overcome”, was published (http://journal.frontiersin.org/researchtopic/3763/surveying-antimicrobial-resistanceapproaches- issues-and-challenges-to-overcome). The problem of antimicrobial resistance (AMR), caused by excessive and inappropriate use of antibiotics, is a public health issue that concerns us all. The introduction of penicillin in the 1940s, the start of the antibiotics era, has been recognized as one of the greatest advances in therapeutic medicine. However, according to the World Health Organization (WHO), AMR infections are now an increasing worldwide public health threat and a post-antibiotic era is imminent, where common infections and minor injuries could be fatal. AMR is a typical ‘One Health’ problem, in which livestock animals and the environment constitute AMR reservoirs and transmission routes to and from the human population. Without effective antimicrobials to counter and prevent infections, other major achievements in modern medicine, such as organ transplantation, cancer chemotherapy and major surgery, risk being compromised. AMR infections in animals have negative outcomes on animal health, welfare, biosecurity and production. In 2006, the ban of growth promoting antibiotics highlighted antibiotic use in animal production as a risk factor in the development of antibiotic resistant bacteria. Bacteria can be transferred to humans via several routes; consumption of animal products, exposure through contact with animals, and the contamination of ground and surface waters by animal waste products. Therefore, it is of utmost importance that antimicrobial use in animals is reduced to a minimum, without compromising animal health and welfare. Mechanisms of bacterial antibiotic resistance are classified according to the types of antibiotic molecules or their targets in the cell. Environmental antibiotic-resistance genes are spread then acquired by clinically relevant microorganisms. Many resistance genes are conveyed into pathogen genomes via mobile genetic elements such as plasmids, transposons or integrons, increasing the propagation of potential resistant pathogens. Substantial progress has already been made in elucidating the basic regulatory networks that endow bacteria with their extraordinary capacity to adapt to a diversity of lifestyles and external stress factors. So how will we face bacteria in the future?

The resistance topic is timely given current events. The emergence of mysterious new diseases, such as SARS, and the looming threat of bioterrorist attacks remind us of how vulnerable we can be to infectious agents. With advances in medical technologies, we have tamed many former microbial foes, yet with few new antimicrobial agents and vaccines in the pipeline, and rapidly increasing drug resistance among infectious microbes, we teeter on the brink of loosing the upperhand in our ongoing struggle against these foes, old and new. The Resistance Phenomenon in Microbes and Infectious Disease Vectors examines our understanding of the relationships among microbes, disease vectors, and human hosts, and explores possible new strategies for meeting the challenge of resistance.

On December 4-5, 2019, the National Academies of Sciences, Engineering, and Medicine held a 1.5-day public workshop titled Exploring the Frontiers of Innovation to Tackle Microbial Threats. The workshop participants examined major advances in scientific, technological, and social innovations against microbial threats. Such innovations include diagnostics, vaccines (both development and production), and antimicrobials, as well as nonpharmaceutical interventions and changes in surveillance. This publication summarizes the presentations and discussions from the workshop.

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.

Summary report published as technical document with reference number: WHO/HSE/PED/AIP/2014.2.

The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.