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Antimicrobial resistance: where are we now?

Antimicrobial resistance is regarded as one of the most pressing problems facing 21st-century healthcare, such that it is the focus of The Longitude Prize 2014. Here, Erin Vaughan provides an overview and update.

It has been estimated that antibiotics add an average of 20 years to all of our lives.1 In the 87 years since the discovery of penicillin, a huge variety of antibiotics have been created. This has made possible an array of innovative medical advances, including organ transplantation and cancer therapy, and helps to save millions of lives every day.

While the development of resistant strains of microorganisms to antimicrobial agents is a natural occurrence, the process has no doubt been accelerated by the misuse and overuse of antibiotics. Bacteria are now developing an abundance of mechanisms that allow them to confer resistance, resulting in the development of resistant strains and untreatable ‘superbugs’.

Particularly worrying is the prevalence of resistance in Gram-negative pathogens, as isolates producing extended-spectrum beta-lactamase (ESBLs), AmpC and carbapenemase enzymes are rapidly disseminating. This has resulted in limited therapeutic treatment options, rendering inconsequential infections life-threatening.

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