Antimicrobial resistance

645:(EPA) and sold to market, showing the widespread use of these agents. It is estimated that for every single meal a person consumes, 0.3 g of pesticides is used, as 90% of all pesticide use is in agriculture. A majority of these products are used to help defend against the spread of infectious diseases, and hopefully protect public health. But out of the large amount of pesticides used, it is also estimated that less than 0.1% of those antimicrobial agents, actually reach their targets. That leaves over 99% of all pesticides used available to contaminate other resources. In soil, air, and water these antimicrobial agents are able to spread, coming in contact with more microorganisms and leading to these microbes evolving mechanisms to tolerate and further resist pesticides. The use of antifungal 405:

approximately 154 million prescriptions for antibiotics are written. Of these, up to 46 million are unnecessary or inappropriate for the condition that the patient has. Microbes may naturally develop resistance through genetic mutations that occur during cell division, and although random mutations are rare, many microbes reproduce frequently and rapidly, increasing the chances of members of the population acquiring a mutation that increases resistance. Many individuals stop taking antibiotics when they begin to feel better. When this occurs, it is possible that the microbes that are less susceptible to treatment still remain in the body. If these microbes are able to continue to reproduce, this can lead to an infection by bacteria that are less susceptible or even resistant to an antibiotic.

1120:(FDA) collect data on antibiotic use in humans and in a more limited fashion in animals. About 80% of antibiotic use in the U.S. is for agriculture purposes, and about 70% of these are medically important. This gives reason for concern about the antibiotic resistance crisis in the U.S. and more reason to monitor it. The FDA first determined in 1977 that there is evidence of emergence of antibiotic-resistant bacterial strains in livestock. The long-established practice of permitting OTC sales of antibiotics (including penicillin and other drugs) to lay animal owners for administration to their own animals nonetheless continued in all states. In 2000, the FDA announced their intention to revoke approval of 1025:

diminishes. The proper use of infrastructure for water, sanitation and hygiene (WASH) can result in a 47–72 percent decrease of diarrhea cases treated with antibiotics depending on the type of intervention and its effectiveness. A reduction of the diarrhea disease burden through improved infrastructure would result in large decreases in the number of diarrhea cases treated with antibiotics. This was estimated as ranging from 5 million in Brazil to up to 590 million in India by the year 2030. The strong link between increased consumption and resistance indicates that this will directly mitigate the accelerating spread of AMR. Sanitation and water for all by 2030 is

1869: 900:(both usually viral in origin) were given prescriptions for antibiotics. These prescriptions accomplished nothing other than increasing the risk of further evolution of antibiotic resistant bacteria. Using antimicrobials without prescription is another driving force leading to the overuse of antibiotics to self-treat diseases like the common cold, cough, fever, and dysentery resulting in an epidemic of antibiotic resistance in countries like Bangladesh, risking its spread around the globe. Introducing strict antibiotic stewardship in the outpatient setting to reduce inappropriate prescribing of antibiotics may reduce the emerging bacterial resistance. 1877: 80: 1545:, under simulated microgravity (LSMMG, or Low Shear Modeled Microgravity) over 1000 generations. The adapted strain acquired resistance to not only chloramphenicol, but also cross-resistance to other antibiotics; this was in contrast to the observation on the same strain, which was adapted to over 1000 generations under LSMMG, but without any antibiotic exposure; the strain in this case did not acquire any such resistance. Thus, irrespective of where they are used, the use of an antibiotic would likely result in persistent resistance to that antibiotic, as well as cross-resistance to other antimicrobials. 668: 1981:, more than "80 pharmaceutical and diagnostic companies" from around the world called for "transformational commercial models" at a global level to spur research and development on antibiotics and on the "enhanced use of diagnostic tests that can rapidly identify the infecting organism". A number of countries are considering or implementing delinked payment models for new antimicrobials whereby payment is based on value rather than volume of drug sales. This offers the opportunity to pay for valuable new drugs even if they are reserved for use in relatively rare drug resistant infections. 1401: 15493: 303:

bacteria to resist the mechanism to kill the microbe associated with certain antibiotics. Clinical resistance is shown through the failure of many therapeutic techniques where the bacteria that are normally susceptible to a treatment become resistant after surviving the outcome of the treatment. In both cases of acquired resistance, the bacteria can pass the genetic catalyst for resistance through horizontal gene transfer: conjugation, transduction, or transformation. This allows the resistance to spread across the same species of pathogen or even similar bacterial pathogens.

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unsuitable way of using them but a common practice in resource-constrained countries. The practice exposes individuals to the risk of bacteria that have developed antimicrobial resistance. Many people resort to this out of necessity, when access to a physician is unavailable due to lockdowns and GP surgery closures, or when the patients have a limited amount of time or money to see a prescribing doctor. This increased access makes it extremely easy to obtain antimicrobials and an example is India, where in the state of

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antibiotics as necessary to avoid failing to provide adequate care. This demonstrates how a majority of doctors underestimate the impact that their own prescribing habits have on antimicrobial resistance as a whole. It also confirms that some physicians may be overly cautious and prescribe antibiotics for both medical or legal reasons, even when clinical indications for use of these medications are not always confirmed. This can lead to unnecessary antimicrobial use, a pattern which may have worsened during the

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of the disease burden and associated resistance. The application of molecular testing to identify genetic markers associating with resistance may improve the identification of antifungal resistance, but the diversity of mutations associated with resistance is increasing across the fungal species causing infection. In addition, a number of resistance mechanisms depend on up-regulation of selected genes (for instance reflux pumps) rather than defined mutations that are amenable to molecular detection.

2138: 498:) and, secondly, broad microbial resistance and when to seek medical care if the infection is not clearing. In order to determine the public's knowledge and preconceived notions on antibiotic resistance, a screening of 3,537 articles published in Europe, Asia, and North America was done. Of the 55,225 total people surveyed in the articles, 70% had heard of antibiotic resistance previously, but 88% of those people thought it referred to some type of physical change in the human body. 2356:(NIHR), European Clinical Research Alliance in Infectious Diseases (ECRAID) and the recently formed ADVANCE-ID, which is a clinical research network based in Asia. The Global Antimicrobial Research and Development Partnership (GARDP) is generating new evidence for global AMR threats such as neonatal sepsis, treatment of serious bacterial infections and sexually transmitted infections as well as addressing global access to new and strategically important antibacterial drugs. 961:

needed won't help the user, but instead give bacteria the option to adapt and leave the user with the side effects that come with the certain type of antibiotic. The CDC recommends that you follow these behaviors so that you avoid these negative side effects and keep the community safe from spreading drug-resistant bacteria. Practicing basic bacterial infection prevention courses, such as hygiene, also helps to prevent the spread of antibiotic-resistant bacteria.

2296:(R&D) efforts have provided new drugs in time to treat bacteria that became resistant to older antibiotics, but in the 2000s there has been concern that development has slowed enough that seriously ill people may run out of treatment options. Another concern is that practitioners may become reluctant to perform routine surgeries because of the increased risk of harmful infection. Backup treatments can have serious side-effects; for example, antibiotics like 15383: 2332:, one of the last major pharmaceutical companies developing new antibiotics, shut down its primary research effort, citing poor shareholder returns relative to drugs for chronic illnesses. However, small and medium-sized pharmaceutical companies are still active in antibiotic drug research. In particular, apart from classical synthetic chemistry methodologies, researchers have developed a combinatorial synthetic biology platform on single cell level in a 583: 18300: 2367:(FDA). These processes are increasingly aligned although important differences remain and drug developers must prepare separate documents. New development pathways have been developed to help with the approval of new antimicrobial agents that address unmet needs such as the Limited Population Pathway for Antibacterial and Antifungal Drugs (LPAD). These new pathways are required because of difficulties in conducting large definitive 15509: 2352:; and Replenishing and Enabling the Pipeline for Anti-infective Resistance Impact Fund (REPAIR). Later stage clinical development is supported by the AMR Action Fund, which in turn is supported by multiple investors with the aim of developing 2–4 new antimicrobial agents by 2030. The delivery of these trials is facilitated by national and international networks supported by the Clinical Research Network of the 1990:

Ensuring compliance of involved parties is a challenge. Global antimicrobial resistance policies could take lessons from the environmental sector by adopting strategies that have made international environmental agreements successful in the past such as: sanctions for non-compliance, assistance for implementation, majority vote decision-making rules, an independent scientific panel, and specific commitments.

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in agriculture increases selective pressure in fungal populations, causing antifungal resistance. As resistance to antimicrobials becomes more common there is a much greater need for alternative treatments. Calls for new antimicrobial therapies have been issued, but there is very little development of new drugs and consequently little innovation in the process of researching potential candidates for them.

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era where common infections and minor injuries can kill, and where complex procedures such as surgery and chemotherapy become too risky, is a very real possibility. Antimicrobial resistance can lead to epidemics of enormous proportions if preventive actions are not taken. In this day and age current antimicrobial resistance leads to longer hospital stays, higher medical costs, and increased mortality.

282: 482:(LMICs) ranges from 8.1% to very high at 93%. Accessibility, affordability, and conditions of health facilities, as well as the health-seeking behavior, are factors that influence self-medication in low- and middle-income countries (LMICs). Two significant issues with self-medication are the lack of knowledge of the public on, firstly, the dangerous effects of certain antimicrobials (for example 18312: 38: 2526:, Poland. Bacteriophage cocktails are common drugs sold over the counter in pharmacies in eastern countries. In Belgium, four patients with severe musculoskeletal infections received bacteriophage therapy with concomitant antibiotics. After a single course of phage therapy, no recurrence of infection occurred and no severe side-effects related to the therapy were detected. 2501:

target multidrug-resistant bacterial infections, and their use involves the added benefit of preventing the elimination of beneficial bacteria in the human body. Phages destroy bacterial cell walls and membrane through the use of lytic proteins which kill bacteria by making many holes from the inside out. Bacteriophages can even possess the ability to digest the

2115:, policymakers can help tackle resistance by strengthening resistance-tracking and laboratory capacity and by regulating and promoting the appropriate use of medicines. Policymakers and industry can help tackle resistance by: fostering innovation and research and development of new tools; and promoting cooperation and information sharing among all stakeholders. 86:: Bacteria are streaked on dishes with white disks, each impregnated with a different antibiotic. Clear rings, such as those on the left, show that bacteria have not grown—indicating that these bacteria are not resistant. The bacteria on the right are fully resistant to three of seven and partially resistant to two of seven antibiotics tested. 549:. Moreover, pandemic burdens on some healthcare systems may contribute to antibiotic-resistant infections. On the other hand, "increased hand hygiene, decreased international travel, and decreased elective hospital procedures may have reduced AMR pathogen selection and spread in the short term" during the COVID-19 pandemic. The use of 2157:

causes of fever, clinicians presume that a non-malarial febrile illness is most likely a bacterial infection, leading to inappropriate use of antibiotics. Multiple studies have shown that the use of malaria rapid diagnostic tests without reliable tools to distinguish other fever causes has resulted in increased antibiotic use.

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resistance and was guided by the advice of countries and key stakeholders. The WHO's global action plan is composed of five key objectives that can be targeted through different means, and represents countries coming together to solve a major problem that can have future health consequences. These objectives are as follows:

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levels of antimicrobial resistance. The main problem is that doctors are willing to prescribe antimicrobials to ill-informed individuals who believe that antimicrobials can cure nearly all illnesses, including viral infections like the common cold. In an analysis of drug prescriptions, 36% of individuals with a cold or an

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Health Protection Surveillance Centre, these were published in 2009. Following their publication a public information campaign 'Action on Antibiotics' was launched to highlight the need for a change in antibiotic prescribing. Despite this, antibiotic prescribing remains high with variance in adherence to guidelines.

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idea of a global tracking system has been suggested but implementation has yet to occur. A system of this nature would provide insight to areas of high resistance as well as information necessary for evaluating programs, introducing interventions and other changes made to fight or reverse antibiotic resistance.

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because vaccines reduce the spread of the infection and target the pathogen in multiple ways in the same host and possibly in different ways between different hosts. Furthermore, if the use of vaccines increases, there is evidence that antibiotic resistant strains of pathogens will decrease; the need

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who said "The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily under-dose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant." Without the creation of new and stronger antibiotics an

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The 1950s to 1970s represented the golden age of antibiotic discovery, where countless new classes of antibiotics were discovered to treat previously incurable diseases such as tuberculosis and syphilis. However, since that time the discovery of new classes of antibiotics has been almost nonexistent,

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Due to the limited number of antifungals in clinical use and the increasing global incidence of antifungal resistance, using the existing antifungals in combination might be beneficial in some cases but further research is needed. Similarly, other approaches that might help to combat the emergence of

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cause most of these infections and antifungal resistance occurs in all of them. Multidrug resistance in fungi is increasing because of the widespread use of antifungal drugs to treat infections in immunocompromised individuals and the use of some agricultural antifungals. Antifungal resistant disease

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in an antibiotic gradient can become resistant. Any heterogeneous environment with respect to nutrient and antibiotic gradients may facilitate antibiotic resistance in small bacterial populations. Researchers hypothesize that the mechanism of resistance evolution is based on four SNP mutations in the

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The increasing interconnectedness of the world and the fact that new classes of antibiotics have not been developed and approved for more than 25 years highlight the extent to which antimicrobial resistance is a global health challenge. A global action plan to tackle the growing problem of resistance

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Recent studies have shown that the prophylactic use of "non-priority" or "non-clinically relevant" antimicrobials in feeds can potentially, under certain conditions, lead to co-selection of environmental AMR bacteria with resistance to medically important antibiotics. The possibility for co-selection

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The prescriber should closely adhere to the five rights of drug administration: the right patient, the right drug, the right dose, the right route, and the right time. Microbiological samples should be taken for culture and sensitivity testing before treatment when indicated and treatment potentially

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There have been increasing public calls for global collective action to address the threat, including a proposal for an international treaty on antimicrobial resistance. Further detail and attention is still needed in order to recognize and measure trends in resistance on the international level; the

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in bacterial populations, killing vulnerable bacteria; this increases the percentage of resistant bacteria, which continue growing. Even very low levels of antibiotic can give resistant bacteria an advantage in growing and reproducing faster than vulnerable bacteria. Similarly, the use of antifungals

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has been shown to influence antimicrobial prescribing rates in this patient cohort, but further research is required to demonstrate an effect on rates of AMR. Clinical investigation to rule out bacterial infections are often done for patients with pediatric acute respiratory infections. Currently it

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The Irish Department of Health published a National Action Plan on Antimicrobial Resistance in October 2017. The Strategy for the Control of Antimicrobial Resistance in Ireland (SARI), Iaunched in 2001 developed Guidelines for Antimicrobial Stewardship in Hospitals in Ireland in conjunction with the

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Water supply and sanitation infrastructure in health facilities offer significant co-benefits for combatting AMR, and investment should be increased. There is much room for improvement: WHO and UNICEF estimated in 2015 that globally 38% of health facilities did not have a source of water, nearly 19%

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Parental expectations, driven by the worry for their children's health, can influence how often children are prescribed antibiotics. Parents often rely on their clinician for advice and reassurance. However a lack of plain language information and not having adequate time for consultation negatively

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By mapping antimicrobial consumption in livestock globally, it was predicted that in 228 countries there would be a total 67% increase in consumption of antibiotics by livestock by 2030. In some countries such as Brazil, Russia, India, China, and South Africa it is predicted that a 99% increase will

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Over time, most of the strains of bacteria and infections present will be the type resistant to the antimicrobial agent being used to treat them, making this agent now ineffective to defeat most microbes. With the increased use of antimicrobial agents, there is a speeding up of this natural process.

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means that organisms that are able to adapt to their environment, survive, and continue to produce offspring. As a result, the types of microorganisms that are able to survive over time with continued attack by certain antimicrobial agents will naturally become more prevalent in the environment, and

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WHO report released April 2014 stated, "this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance—when bacteria change so antibiotics no longer work in

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Acute febrile illness is a common reason for seeking medical care worldwide and a major cause of morbidity and mortality. In areas with decreasing malaria incidence, many febrile patients are inappropriately treated for malaria, and in the absence of a simple diagnostic test to identify alternative

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The identification of antifungal resistance is undermined by limited classical diagnosis of infection, where a culture is lacking, preventing susceptibility testing. National and international surveillance schemes for fungal disease and antifungal resistance are limited, hampering the understanding

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occurring at a rate of about 1 in 10 to 1 in 10 per chromosomal replication, the fact that bacteria reproduce at a high rate allows for the effect to be significant. Given that lifespans and production of new generations can be on a timescale of mere hours, a new (de novo) mutation in a parent cell

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where the spread of infectious diseases caused by inadequate WASH standards is a major driver of antibiotic demand. Growing usage of antibiotics together with persistent infectious disease levels have led to a dangerous cycle in which reliance on antimicrobials increases while the efficacy of drugs

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infrastructure needs to be included in the antimicrobial resistance (AMR) agenda. The "Interagency Coordination Group on Antimicrobial Resistance" stated in 2018 that "the spread of pathogens through unsafe water results in a high burden of gastrointestinal disease, increasing even further the need

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teams in hospitals are encouraging optimal use of antimicrobials. The goals of antimicrobial stewardship are to help practitioners pick the right drug at the right dose and duration of therapy while preventing misuse and minimizing the development of resistance. Stewardship interventions may reduce

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Excessive antimicrobial use has become one of the top contributors to the evolution of antimicrobial resistance. Since the beginning of the antimicrobial era, antimicrobials have been used to treat a wide range of infectious diseases. Overuse of antimicrobials has become the primary cause of rising

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Delaying or minimizing the use of antibiotics for certain conditions may help safely reduce their use. Antimicrobial treatment duration should be based on the infection and other health problems a person may have. For many infections once a person has improved there is little evidence that stopping

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Important to the conversation of antibiotic use is the veterinary medical system. Veterinary oversight is required by law for all medically important antibiotics. Veterinarians use the Pharmacokinetic/pharmacodynamic model (PK/PD) approach to ensuring that the correct dose of the drug is delivered

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According to research conducted in the US that aimed to evaluate physicians' attitudes and knowledge on antimicrobial resistance in ambulatory settings, only 63% of those surveyed reported antibiotic resistance as a problem in their local practices, while 23% reported the aggressive prescription of

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by consumers is defined as "the taking of medicines on one's own initiative or on another person's suggestion, who is not a certified medical professional", and it has been identified as one of the primary reasons for the evolution of antimicrobial resistance. Self-medication with antibiotics is an

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when possible, for effectively and accurately targeting specific organisms is less likely to cause resistance as well as side effects. For people who take these medications at home, education about proper use is essential. Health care providers can minimize the spread of resistant infections by use

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Phage therapy relies on the use of naturally occurring bacteriophages to infect and lyse bacteria at the site of infection in a host. Due to current advances in genetics and biotechnology these bacteriophages can possibly be manufactured to treat specific infections. Phages can be bioengineered to

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Alternating therapy is a proposed method in which two or three antibiotics are taken in a rotation versus taking just one antibiotic such that bacteria resistant to one antibiotic are killed when the next antibiotic is taken. Studies have found that this method reduces the rate at which antibiotic

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Distinguishing infections requiring antibiotics from self-limiting ones is clinically challenging. In order to guide appropriate use of antibiotics and prevent the evolution and spread of antimicrobial resistance, diagnostic tests that provide clinicians with timely, actionable results are needed.

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caused a reversal of much of the progress made on attenuating the effects of antibiotic resistance, resulting in more antibiotic use, more resistant infections, and less data on preventive action. Hospital-onset infections and deaths both increased by 15% in 2020, and significantly higher rates of

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Clinical misuse by healthcare professionals is another contributor to increased antimicrobial resistance. Studies done in the US show that the indication for treatment of antibiotics, choice of the agent used, and the duration of therapy was incorrect in up to 50% of the cases studied. In 2010 and

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that was once able to treat an infection by that microorganism. A person cannot become resistant to antibiotics. Resistance is a property of the microbe, not a person or other organism infected by a microbe. All types of microbes can develop drug resistance. Thus, there are antibiotic, antifungal,

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Rising drug resistance is caused mainly by use of antimicrobials in humans and other animals and the spread of AMR strains between the two. Growing resistance has also been linked to releasing inadequately treated effluents from the pharmaceutical industry, especially in countries where bulk drugs

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innovations, is defined as "being feasible within an 8-h working shift". There are several commercial Food and Drug Administration-approved assays available which can detect AMR genes from a variety of specimen types. Progress has been slow due to a range of reasons including cost and regulation.

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Measuring the costs and benefits of strategies to combat AMR is difficult and policies may only have effects in the distant future. In other infectious diseases this problem has been addressed by using mathematical models. More research is needed to understand how AMR develops and spreads so that

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with the intent of providing a roadmap to guide the US in the antibiotic resistance challenge and with hopes of saving many lives. This plan outlines steps taken by the Federal government over the next five years needed in order to prevent and contain outbreaks of antibiotic-resistant infections;

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and other penicillin-resistant bacteria. Another protective mechanism found among bacterial species is ribosomal protection proteins. These proteins protect the bacterial cell from antibiotics that target the cell's ribosomes to inhibit protein synthesis. The mechanism involves the binding of the

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People can help tackle resistance by using antibiotics only when infected with a bacterial infection and prescribed by a doctor; completing the full prescription even if the user is feeling better, never sharing antibiotics with others, or using leftover prescriptions. Taking antibiotics when not

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in the United States were not necessary. Another study in an intensive care unit in a major hospital in France has shown that 30% to 60% of prescribed antibiotics were unnecessary. These inappropriate uses of antimicrobial agents promote the evolution of antimicrobial resistance by supporting the

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Antimicrobial resistance is mainly caused by the overuse/misuse of antimicrobials. This leads to microbes either evolving a defense against drugs used to treat them, or certain strains of microbes that have a natural resistance to antimicrobials becoming much more prevalent than the ones that are

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Antibiotic resistance is a subset of antimicrobial resistance. This more specific resistance is linked to bacteria and thus broken down into two further subsets, microbiological and clinical. Microbiological resistance is the most common and occurs from genes, mutated or inherited, that allow the

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and gold nanoparticles (AuNPs) are extensively studied, disrupting bacterial cell membranes and interfering with protein synthesis. Zinc oxide (ZnO NPs), copper (CuNPs), and silica (SiNPs) nanoparticles also exhibit antimicrobial properties. However, high synthesis costs, potential toxicity, and

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The potential crisis at hand is the result of a marked decrease in industry research and development. Poor financial investment in antibiotic research has exacerbated the situation. The pharmaceutical industry has little incentive to invest in antibiotics because of the high risk and because the

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approach to treatment by helping clinicians to prescribe more effective and targeted antimicrobial therapy. At the same time with traditional phenotypic AST it can take 12 to 48 hours to obtain a result due to the time taken for organisms to grow on/in culture media. Rapid testing, possible from

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infections in humans. Legal challenges from the food animal and pharmaceutical industries delayed the final decision to do so until 2006. Fluroquinolones have been banned from extra-label use in food animals in the USA since 2007. However, they remain widely used in companion and exotic animals.

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protect crops against insects and plants, but in some cases antimicrobial pesticides are used to protect against various microorganisms such as bacteria, viruses, fungi, algae, and protozoa. The overuse of many pesticides in an effort to have a higher yield of crops has resulted in many of these

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Clinical conditions due to infections caused by microbes containing AMR cause millions of deaths each year. In 2019 there were around 1.27 million deaths globally caused by bacterial AMR. Infections caused by resistant microbes are more difficult to treat, requiring higher doses of antimicrobial

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Some global health scholars have argued that a global, legal framework is needed to prevent and control antimicrobial resistance. For instance, binding global policies could be used to create antimicrobial use standards, regulate antibiotic marketing, and strengthen global surveillance systems.

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The World Health Organization has promoted the first World Antibiotic Awareness Week running from 16 to 22 November 2015. The aim of the week is to increase global awareness of antibiotic resistance. It also wants to promote the correct usage of antibiotics across all fields in order to prevent

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Farmers typically use antibiotics in animal feed to improve growth rates and prevent infections. However, this is illogical as antibiotics are used to treat infections and not prevent infections. 80% of antibiotic use in the U.S. is for agricultural purposes and about 70% of these are medically

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of a fully resistant colony. However, chromosomal mutations also confer a cost of fitness. For example, a ribosomal mutation may protect a bacterial cell by changing the binding site of an antibiotic but may result in slower growth rate. Moreover, some adaptive mutations can propagate not only

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The antimicrobial resistance crisis also extends to the food industry, specifically with food producing animals. With an ever-increasing human population, there is constant pressure to intensify productivity in many agricultural sectors, including the production of meat as a source of protein.

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Some contemporary antimicrobial resistances have also evolved naturally before the use of antimicrobials of human clinical uses. For instance, methicillin-resistance evolved as a pathogen of hedgehogs, possibly as a co-evolutionary adaptation of the pathogen to hedgehogs that are infected by a

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Studies have found that bacteria that evolve antibiotic resistance towards one group of antibiotic may become more sensitive to others. This phenomenon can be used to select against resistant bacteria using an approach termed collateral sensitivity cycling, which has recently been found to be

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convened the Interagency Coordination Group (IACG) on Antimicrobial Resistance. The IACG worked with international organizations and experts in human, animal, and plant health to create a plan to fight antimicrobial resistance. Their report released in April 2019 highlights the seriousness of

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in May 2015. One of the key objectives of the plan is to improve awareness and understanding of antimicrobial resistance through effective communication, education and training. This global action plan developed by the World Health Organization was created to combat the issue of antimicrobial

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and four additional antibiotics used to promote animal growth in 1999. In 2006 a ban on the use of antibiotics in European feed, with the exception of two antibiotics in poultry feeds, became effective. In Scandinavia, there is evidence that the ban has led to a lower prevalence of antibiotic

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Delaying antibiotics for ailments such as a sore throat and otitis media may have not different in the rate of complications compared with immediate antibiotics, for example. When treating respiratory tract infections, clinical judgement is required as to the appropriate treatment (delayed or

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Given the volume of care provided in primary care (general practice), recent strategies have focused on reducing unnecessary antimicrobial prescribing in this setting. Simple interventions, such as written information explaining when taking antibiotics is not necessary, for example in common

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The study, "Shorter and Longer Antibiotic Durations for Respiratory Infections: To Fight Antimicrobial Resistance—A Retrospective Cross-Sectional Study in a Secondary Care Setting in the UK," highlights the urgency of reevaluating antibiotic treatment durations amidst the global challenge of

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products, it is a major issue and needs to be decreased in order to prevent antimicrobial resistance. Though the evidence linking antimicrobial usage in livestock to antimicrobial resistance is limited, the World Health Organization Advisory Group on Integrated Surveillance of Antimicrobial

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important. Overusing antibiotics gives the bacteria time to adapt leaving higher doses or even stronger antibiotics needed to combat the infection. Though antibiotics for growth promotion were banned throughout the EU in 2006, 40 countries worldwide still use antibiotics to promote growth.

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antimicrobial resistance (AMR). It investigates the effectiveness of shorter versus longer antibiotic regimens for respiratory tract infections (RTIs) in a UK secondary care setting, emphasizing the need for evidence-based prescribing practices to optimize patient outcomes and combat AMR.

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resistance in (nonhazardous) animal bacterial populations. As of 2004, several European countries established a decline of antimicrobial resistance in humans through limiting the use of antimicrobials in agriculture and food industries without jeopardizing animal health or economic cost.

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Although many microbes develop resistance to antibiotics over time though natural mutation, overprescribing and inappropriate prescription of antibiotics have accelerated the problem. It is possible that as many as 1 in 3 prescriptions written for antibiotics are unnecessary. Every year,

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Baur D, Gladstone BP, Burkert F, Carrara E, Foschi F, Döbele S, et al. (September 2017). "Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis".

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ribosomal protection proteins to the ribosomes of the bacterial cell, which in turn changes its conformational shape. This allows the ribosomes to continue synthesizing proteins essential to the cell while preventing antibiotics from binding to the ribosome to inhibit protein synthesis.

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impacts this relationship. In effect parents often rely on past experiences in their expectations rather than reassurance from the clinician. Adequate time for consultation and plain language information can help parents make informed decisions and avoid unnecessary antibiotic use.

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easily defeated with medication. While antimicrobial resistance does occur naturally over time, the use of antimicrobial agents in a variety of settings both within the healthcare industry and outside of has led to antimicrobial resistance becoming increasingly more prevalent.

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measurement has been shown to reduce mortality rate, antimicrobial consumption and antimicrobial-related side-effects in patients with respiratory infections, but impact on AMR has not yet been demonstrated. Similarly, point of care serum testing of the inflammatory biomarker

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Resistance strongly recommended the reduction of use of medically important antimicrobials in livestock. Additionally, the Advisory Group stated that such antimicrobials should be expressly prohibited for both growth promotion and disease prevention in food producing animals.

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Merck tested V710, a vaccine targeting IsdB, in a blinded randomized trial in patients undergoing median sternotomy. The trial was terminated after a higher rate of multiorgan system failure–related deaths was found in the V710 recipients. Vaccine recipients who developed

449:. This means that once a gene for resistance to an antibiotic appears in a microbial community, it can then spread to other microbes in the community, potentially moving from a non-disease causing microbe to a disease-causing microbe. This process is heavily driven by the 1213:. The inclusion of these pathogens in the list underscores their global impact in terms of burden, as well as issues related to transmissibility, treatability, and prevention options. It also reflects the R&D pipeline of new treatments and emerging resistance trends. 1771:

as a potential human pathogen that sometimes exhibits multi-class antifungal drug resistance is concerning and has been associated with several outbreaks globally. The WHO has released a priority fungal pathogen list, including pathogens with antifungal resistance.

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Some of the economic impediments to the development of new antimicrobial agents have been addressed by innovative reimbursement schemes that delink payment of antimicrobials from volume-based sales. In the UK, a market entry reward scheme has been pioneered by the

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reported that the total number of antibiotic resistant infections in England rose by 9% from 55,812 in 2017 to 60,788 in 2018, but antibiotic consumption had fallen by 9% from 20.0 to 18.2 defined daily doses per 1,000 inhabitants per day between 2014 and 2018.

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Health workers and pharmacists can help tackle antibiotic resistance by: enhancing infection prevention and control; only prescribing and dispensing antibiotics when they are truly needed; prescribing and dispensing the right antibiotic(s) to treat the illness.

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Diagram showing the difference between non-resistant bacteria and drug resistant bacteria. Non-resistant bacteria multiply, and upon drug treatment, the bacteria die. Drug resistant bacteria multiply as well, but upon drug treatment, the bacteria continue to

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Ancient bacteria found in the permafrost possess a remarkable range of genes which confer resistance to some of the most common antimicrobial classes (red). However, their capacity to resist is also generally lower than of modern bacteria from the same area

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infection. In a phase II trial, a bivalent vaccine of capsular proteins 5 & 8 was tested in 1804 hemodialysis patients with a primary fistula or synthetic graft vascular access. After 40 weeks following vaccination a protective effect was seen against

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The United Kingdom published a 20-year vision for antimicrobial resistance that sets out the goal of containing and controlling AMR by 2040. The vision is supplemented by a 5-year action plan running from 2019 to 2024, building on the previous action plan

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can give rise to AMR resistances in bacteria found in food animals to the antibiotics being administered (through injections or medicated feeds). For this reason only antimicrobials that are deemed "not-clinically relevant" are used in these practices.

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calculated that in 2015 there were 671,689 infections in the EU and European Economic Area caused by antibiotic-resistant bacteria, resulting in 33,110 deaths. Most were acquired in healthcare settings. In 2019 there were 133,000 deaths caused by AMR.

2465:". In doing so, a profile of these genes within a community or environment can be determined, providing insights into how antimicrobial resistance is spreading through a population and allowing for the identification of resistance that is of concern. 2447:

One of the key tools identified by the WHO and others for the fight against rising antimicrobial resistance is improved surveillance of the spread and movement of AMR genes through different communities and regions. Recent advances in high-throughput

2176:

Optical techniques such as phase contrast microscopy in combination with single-cell analysis are another powerful method to monitor bacterial growth. In 2017, scientists from Uppsala University in Sweden published a method that applies principles of

2438:

Similar to the situation in malaria therapy, where successful treatments based on ancient recipes have been found, there has already been some success in finding and testing ancient drugs and other treatments that are effective against AMR bacteria.

1651:; however, HIV-1 reverse transcriptase is highly error prone and thus mutations conferring resistance arise rapidly. Resistant strains of the HIV virus emerge rapidly if only one antiviral drug is used. Using three or more drugs together, termed 2068:

The Action Plan was developed around five goals with focuses on strengthening health care, public health veterinary medicine, agriculture, food safety and research, and manufacturing. These goals, as listed by the White House, are as follows:

562:

Untreated effluents from pharmaceutical manufacturing industries, hospitals and clinics, and inappropriate disposal of unused or expired medication can expose microbes in the environment to antibiotics and trigger the evolution of resistance.

6388:

Fox-Kemper, B., H.T. Hewitt, C. Xiao, G. Aðalgeirsdóttir, S.S. Drijfhout, T.L. Edwards, N.R. Golledge, M. Hemer, R.E. Kopp, G. Krinner, A. Mix, D. Notz, S. Nowicki, I.S. Nurhati, L. Ruiz, J.-B. Sallée, A.B.A. Slangen, and Y. Yu, 2021:

2456:

have resulted in the ability to determine the individual microbial genes in a sample. Along with the availability of databases of known antimicrobial resistance genes, such as the Comprehensive Antimicrobial Resistance Database (CARD) and

1968:

Since the mid-1980s pharmaceutical companies have invested in medications for cancer or chronic disease that have greater potential to make money and have "de-emphasized or dropped development of antibiotics". On 20 January 2016 at the

598:

This can result in the transfer of resistant bacterial strains into the food that humans eat, causing potentially fatal transfer of disease. While the practice of using antibiotics as growth promoters does result in better yields and

2430:

instability pose challenges. To overcome these, biological synthesis methods and combination therapies with other antimicrobials are explored. Enhanced biocompatibility and targeting are also under investigation to improve efficacy.

2215:

for antibiotics will naturally decrease as vaccines prevent infection before it occurs. However, there are well documented cases of vaccine resistance, although these are usually much less of a problem than antimicrobial resistance.

477:

Self-medication is higher outside the hospital environment, and this is linked to higher use of antibiotics, with the majority of antibiotics being used in the community rather than hospitals. The prevalence of self-medication in

679:

is a term used to refer to any ground that remained frozen for two years or more, with the oldest known examples continuously frozen for around 700,000 years. In the recent decades, permafrost has been rapidly thawing due to

2249:

Numerous investigators have suggested that a multiple-antigen vaccine would be more effective, but a lack of biomarkers defining human protective immunity keep these proposals in the logical, but strictly hypothetical arena.

907:(Access, Watch, Reserve) guidance and antibiotic book has been introduced to guide antibiotic choice for the 30 most common infections in adults and children to reduce inappropriate prescribing in primary care and hospitals. 891:

appear useful in reducing rates of antimicrobial resistance. The antimicrobial stewardship program will also provide pharmacists with the knowledge to educate patients that antibiotics will not work for a virus for example.

918:

Various diagnostic strategies have been employed to prevent the overuse of antifungal therapy in the clinic, proving a safe alternative to empirical antifungal therapy, and thus underpinning antifungal stewardship schemes.

2258:

Antibodies are promising against antimicrobial resistance. Monoclonal antibodies (mAbs) target bacterial virulence factors, aiding in bacterial destruction through various mechanisms. Three FDA-approved antibodies target

553:

such as alcohol-based hand sanitizers, and antiseptic hand wash may also have the potential to increase antimicrobial resistance. Extensive use of disinfectants can lead to mutations that induce antimicrobial resistance.

4206: 2343:

In the 5–10 years since 2010, there has been a significant change in the ways new antimicrobial agents are discovered and developed – principally via the formation of public-private funding initiatives. These include

852:

which displays aggregated data on antimicrobial resistance from publicly available and user submitted data. The website can display data for a 25 miles (40 km) radius from a location. Users may submit data from

11853: 11823: 2424:

have demonstrated appealing features for the development of a new family of antimicrobial agents. Nanoparticles (1-100 nm) show unique properties and promise as antimicrobial agents against resistant bacteria.

1929:

reported that more than 2.8 million cases of antibiotic resistance have been reported. However, in 2019 overall deaths from antibiotic-resistant infections decreased by 18% and deaths in hospitals decreased by 30%.

11583: 4766:

Torres NF, Chibi B, Middleton LE, Solomon VP, Mashamba-Thompson TP (March 2019). "Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review".

1819:

Malarial parasites that are resistant to the drugs that are currently available to infections are common and this has led to increased efforts to develop new drugs. Resistance to recently developed drugs such as

1243:

antimicrobial resistance and the threat it poses to world health. It suggests five recommendations for member states to follow in order to tackle this increasing threat. The IACG recommendations are as follows:

238:, at least 2.8 million people become infected with antibiotic-resistant bacteria, at least 35,000 of them die, and US$ 55 billion is spent on all their health care costs and lost productivity. According to the 14179:

Drago L, De Vecchi E, Bortolin M, Toscano M, Mattina R, Romanò CL (August 2015). "Antimicrobial activity and resistance selection of different bioglass S53P4 formulations against multidrug resistant strains".

6453: 6423: 15386: 8047: 6067: 793:

treatment causes more resistance. Some, therefore, feel that stopping early may be reasonable in some cases. Other infections, however, do require long courses regardless of whether a person feels better.

2619: 11148: 6705: 14301: 9170: 4137:"Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis" 2390:

The available classes of antifungal drugs are still limited but as of 2021 novel classes of antifungals are being developed and are undergoing various stages of clinical trials to assess performance.

315:

Global deaths attributable to AMR numbered 1.27 million in 2019. That year, AMR may have contributed to 5 million deaths and one in five people who died due to AMR were children under five years old.

2173:

Genotypic AMR characterisation methods are, however, being increasingly used in combination with machine learning algorithms in research to help better predict phenotypic AMR from organism genotype.

940:

infections of the upper respiratory tract, have been shown to reduce antibiotic prescribing. Various tools are also available to help professionals decide if prescribing antimicrobials is necessary.

8140:

Swoboda SM, Earsing K, Strauss K, Lane S, Lipsett PA (February 2004). "Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit".

1601:

are used to treat some viral infections. These drugs prevent viruses from reproducing by inhibiting essential stages of the virus's replication cycle in infected cells. Antivirals are used to treat

1161:

develop the economic case for sustainable investment that takes account of the needs of all countries and to increase investment in new medicines, diagnostic tools, vaccines and other interventions.

11035: 3463: 2060:

released a comprehensive plan to address the increasing need for agencies to combat the rise of antibiotic-resistant bacteria. The Task Force for Combating Antibiotic-Resistant Bacteria developed

8055: 5283: 1900:

provides the Global Antimicrobial Resistance and Use Surveillance System (GLASS) reports which summarize annual (e.g. 2020's) data on international AMR, also including an interactive dashboard.

1226:

World Antibiotic Awareness Week has been held every November since 2015. For 2017, the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the

6120:

Ramakrishnan B, Venkateswarlu K, Sethunathan N, Megharaj M (March 2019). "Local applications but global implications: Can pesticides drive microorganisms to develop antimicrobial resistance?".

5946:"Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis" 3703: 608:

occur. Several countries have restricted the use of antibiotics in livestock, including Canada, China, Japan, and the US. These restrictions are sometimes associated with a reduction of the

3159: 2045:

proposed to nearly double the amount of federal funding to "combat and prevent" antibiotic resistance to more than $ 1.2 billion. Many international funding agencies like USAID, DFID,

1647:

Resistance to HIV antivirals is problematic, and even multi-drug resistant strains have evolved. One source of resistance is that many current HIV drugs, including NRTIs and NNRTIs, target

13596: 13338: 9040:"WHO bacterial priority pathogens list, 2024: Bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance" 174:

is a subset of AMR, that specifically applies to fungi that have become resistant to antifungals. Resistance to antifungals can arise naturally, for example by genetic mutation or through

14065:

Leppäranta O, Vaahtio M, Peltola T, Zhang D, Hupa L, Hupa M, et al. (February 2008). "Antibacterial effect of bioactive glasses on clinically important anaerobic bacteria in vitro".

6727:

Sajjad W, Rafiq M, Din G, Hasan F, Iqbal A, Zada S, et al. (September 2020). "Resurrection of inactive microbes and resistome present in the natural frozen world: Reality or myth?".

4356: 727:

to survive being frozen and thawed makes this threat unlikely. Instead, there have been suggestions that when modern pathogenic bacteria interact with the ancient ones, they may, through

15048:

Superbugs and superdrugs : a history of MRSA : the transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 11 July 2006

1283:

Diagram depicting antibiotic resistance through alteration of the antibiotic's target site, modeled after MRSA's resistance to penicillin. Beta-lactam antibiotics permanently inactivate

7001:

Spurling GK, Dooley L, Clark J, Askew DA (October 2023). Cochrane Acute Respiratory Infections Group (ed.). "Immediate versus delayed versus no antibiotics for respiratory infections".

3125: 14122:

Munukka E, Leppäranta O, Korkeamäki M, Vaahtio M, Peltola T, Zhang D, et al. (January 2008). "Bactericidal effects of bioactive glasses on clinically important aerobic bacteria".

9017: 8660: 5127:

Harris A, Chandramohan S, Awali RA, Grewal M, Tillotson G, Chopra T (August 2019). "Physicians' attitude and knowledge regarding antibiotic use and resistance in ambulatory settings".

4028: 4002: 735:

which are associated with antimicrobial resistance, exacerbating an already difficult issue. Antibiotics to which permafrost bacteria have displayed at least some resistance include

2505:

that many bacteria develop that protect them from antibiotics in order to effectively infect and kill bacteria. Bioengineering can play a role in creating successful bacteriophages.

1185:

The World Health Organization has published the 2024 Bacterial Priority Pathogens List which covers 15 families of antibiotic-resistant bacterial pathogens. Notable among these are

649:

pesticides that drive environmental azole resistance have been linked to azole resistance cases in the clinical setting. The same issues confront the novel antifungal classes (e.g.

166:, or by one species acquiring resistance from another. Resistance can appear spontaneously because of random mutations, but also arises through spreading of resistant genes through 11946:"Impact of introduction of rapid diagnostic tests for malaria on antibiotic prescribing: analysis of observational and randomised studies in public and private healthcare settings" 234:. Estimates are that 700,000 to several million deaths worldwide result annually from antibiotic resistance, so it continues to pose a major public health threat. Each year in the 7042:"Shorter and Longer Antibiotic Durations for Respiratory Infections: To Fight Antimicrobial Resistance-A Retrospective Cross-Sectional Study in a Secondary Care Setting in the UK" 1947:

and represents a situation that is especially problematic considering the resiliency of bacteria shown over time and the continued misuse and overuse of antibiotics in treatment.

12007: 2348:, which focuses on nonclinical and early phase development of novel antibiotics, vaccines, rapid diagnostics; Novel Gram Negative Antibiotic (GNA-NOW), which is part of the EU's 4198: 14275: 6792:

Miner KR, D'Andrilli J, Mackelprang R, Edwards A, Malaska MJ, Waldrop MP, et al. (30 September 2021). "Emergent biogeochemical risks from Arctic permafrost degradation".

1644:, while guanosine analogs inhibit viral DNA polymerase. Resistance to antivirals is thus acquired through mutations in the genes that encode the protein targets of the drugs. 8614: 2508:

Understanding the mutual interactions and evolutions of bacterial and phage populations in the environment of a human or animal body is essential for rational phage therapy.

11737: 7833: 2393:

Scientists have started using advanced computational approaches with supercomputers for the development of new antibiotic derivatives to deal with antimicrobial resistance.

11843: 11820: 5356: 1860:

is caused by protozoa and is an important public health problem worldwide, especially in sub-tropical and tropical countries. Drug resistance has "become a major concern".

1701:) exhibit intrinsic resistance to certain antifungal drugs or classes, whereas some species develop antifungal resistance to external pressures. Antifungal resistance is a 13845: 2673:"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance" 9646:

Ochiai K, Yamanaka T, Kimura K, Sawada O, O (1959). "Inheritance of drug resistance (and its transfer) between Shigella strains and Between Shigella and E.coli strains".

2401:

Using antibiotic-free alternatives in bone infection treatment may help decrease the use of antibiotics and thus antimicrobial resistance. The bone regeneration material

14470:"ResFinder – an open online resource for identification of antimicrobial resistance genes in next-generation sequencing data and prediction of phenotypes from genotypes" 13970: 12820:"Mortality among recipients of the Merck V710 Staphylococcus aureus vaccine after postoperative S. aureus infections: an analysis of possible contributing host factors" 8504:

Angulo FJ, Baker NL, Olsen SJ, Anderson A, Barrett TJ (April 2004). "Antimicrobial use in agriculture: controlling the transfer of antimicrobial resistance to humans".

7800: 3734: 915:

are only recommended for people with more severe symptoms. Some antibiotics are more likely to confer resistance, so are kept as reserve antibiotics in the AWaRe book.

442:

rapidly lost clinical effectiveness in treating humans and, furthermore, none of the other natural penicillins (F, K, N, X, O, U1 or U6) are currently in clinical use.

8987: 6445: 6415: 5840: 3191:"Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections" 15179:

Goossens H, Ferech M, Vander Stichele R, Elseviers M (2005). "Outpatient antibiotic use in Europe and association with resistance: a cross-national database study".

8189: 2267:

toxins. Innovative strategies include DSTA4637S, an antibody-antibiotic conjugate, and MEDI13902, a bispecific antibody targeting Pseudomonas aeruginosa components.

8693: 16593: 13306: 5922: 1520:

to examine the mechanisms of gene transfer or to identify individuals that absorbed a piece of DNA that included the resistance gene and another gene of interest.

13700: 9069: 8044: 6059: 5189: 982:(DDD) per 1,000 people per day in 2011. The defined daily dose (DDD) is a statistical measure of drug consumption, defined by the World Health Organization (WHO). 11516: 8715: 2284:. Despite its promise, large-scale clinical and experimental studies revealed limited evidence of susceptibility to antibiotic cycling across various pathogens. 9099: 6402:

Climate Change 2021: The Physical Science Basis. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change

2616: 105:(drugs used to treat infections). All classes of microbes can evolve resistance to the point that one or more drugs used to fight them are no longer effective. 11138: 7713:"Written information for patients (or parents of child patients) to reduce the use of antibiotics for acute upper respiratory tract infections in primary care" 6695: 14297: 9163: 3581: 1396:, which is a homologue of HflX from other bacteria. Liberation of the ribosome from the drug allows further translation and consequent resistance to the drug. 148:. Although antimicrobial resistance is a naturally occurring process, it is often the result of improper usage of the drugs and management of the infections. 17477: 11575: 11541: 5437: 9132: 6393: 2046: 13638: 10994: 9802:"Transduction of drug resistance to tetracycline, chloramphenicol, macrolides, lincomycin and clindamycin with phages induced from Streptococcus pyogenes" 6098: 4403: 3455: 11178: 8017: 5275: 15527: 862: 858: 763:. However, other studies show that resistance levels in ancient bacteria to modern antibiotics remain lower than in the contemporary bacteria from the 388: 10487:

Ton Q, Frenkel L (March 2013). "HIV drug resistance in mothers and infants following use of antiretrovirals to prevent mother-to-child transmission".

2181:

and cell tracking, to monitor bacterial response to antibiotics in less than 30 minutes overall manipulation time. This invention was awarded the 8M£

2085:

Improve International Collaboration and Capacities for Antibiotic Resistance Prevention, Surveillance, Control and Antibiotic Research and Development

12689: 7894: 7455: 2376: 4113: 621:

All medically important antibiotics to be used in feed or water for food animal species require a veterinary feed directive (VFD) or a prescription.

8898: 3687: 857:

for individual hospitals or laboratories. European data is from the EARS-Net (European Antimicrobial Resistance Surveillance Network), part of the

662: 13330: 11657:

Behdinan A, Hoffman SJ, Pearcey M (2015). "Some Global Policies for Antibiotic Resistance Depend on Legally Binding and Enforceable Commitments".

11327: 3167: 15572: 14958:"Bacteriophage Application for Difficult-to-treat Musculoskeletal Infections: Development of a Standardized Multidisciplinary Treatment Protocol" 13588: 8085: 2824: 2591: 2353: 14559: 12444:

Smedemark SA, Aabenhus R, Llor C, Fournaise A, Olsen O, Jørgensen KJ, et al. (Cochrane Acute Respiratory Infections Group) (October 2022).

4928:"Fluoroquinolone-associated suspected tendonitis and tendon rupture: A pharmacovigilance analysis from 2016 to 2021 based on the FAERS database" 4310: 3539: 3013:

Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A, et al. (Antimicrobial Resistance Collaborators) (February 2022).

641:

microbes evolving a tolerance against these antimicrobial agents. Currently there are over 4000 antimicrobial pesticides registered with the US

17915: 13153:"Identification of antibiotic pairs that evade concurrent resistance via a retrospective analysis of antimicrobial susceptibility test results" 2222:

species, and the limited duration of effectiveness of the antibodies produced. Development and testing of more effective vaccines is underway.

15513: 4088: 3106: 2359:

The discovery and development of new antimicrobial agents has been facilitated by regulatory advances, which have been principally led by the

2192:

Rapid diagnostic methods have also been trialled as antimicrobial stewardship interventions to influence the healthcare drivers of AMR. Serum

9009: 8811: 8637: 7161: 4634:

Ferri M, Ranucci E, Romagnoli P, Giaccone V (September 2017). "Antimicrobial resistance: A global emerging threat to public health systems".

4024: 3994: 642: 9047: 17469: 16586: 15317: 15030: 8567:"Fluoroquinolone-resistant Campylobacter species and the withdrawal of fluoroquinolones from use in poultry: a public health success story" 2234:

bacteremia, but not at 54 weeks following vaccination. Based on these results, a second trial was conducted which failed to show efficacy.

14377:"CARD 2023: expanded curation, support for machine learning, and resistome prediction at the Comprehensive Antibiotic Resistance Database" 10120:"Colonization of intestinal microbiota with carbapenemase-producing Enterobacteriaceae in paediatric intensive care units in Cairo, Egypt" 8751: 3294: 2536: 1343: 1288: 810: 11802:

Andresen S, Hoffman SJ (2015). "Much Can Be Learned about Addressing Antibiotic Resistance from Multilateral Environmental Agreements".

11264: 7351:"Analysis of medication use patterns:apparent overuse of antibiotics and underuse of prescription drugs for asthma, depression, and CHF" 3327: 15250: 12381:

Schuetz P, Wirz Y, Sager R, Christ-Crain M, Stolz D, Tamm M, et al. (Cochrane Acute Respiratory Infections Group) (October 2017).

12015: 10220:"Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study" 7949: 7550:"Lessons from an Educational Invasive Fungal Disease Conference on Hospital Antifungal Stewardship Practices across the UK and Ireland" 6301:"Functional characterization of bacteria isolated from ancient arctic soil exposes diverse resistance mechanisms to modern antibiotics" 2571: 1926: 817: 7487:"Antibiotic-Resistant Bacteremia in Young Children Hospitalized With Pneumonia in Bangladesh Is Associated With a High Mortality Rate" 4487: 1230:(OIE) are together calling for responsible use of antibiotics in humans and animals to reduce the emergence of antibiotic resistance. 242:(WHO) estimates, 350 million deaths could be caused by AMR by 2050. By then, the yearly death toll will be 10 million, according to a 55: 15722: 14267: 11230: 8201: 7104: 3664: 1523:

Recent findings show no necessity of large populations of bacteria for the appearance of antibiotic resistance. Small populations of

15163: 12446:"Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care" 4285: 2957:"Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019" 11759:

Rizvi Z, Hoffman SJ (2015). "Effective Global Action on Antibiotic Resistance Requires Careful Consideration of Convening Forums".

11208: 10723: 9765:

Hotchkiss RD (1951). "Transfer of penicillin resistance in pneumococci by the desoxyribonucleate derived from resistant cultures".

8606: 3261: 2218:

While theoretically promising, antistaphylococcal vaccines have shown limited efficacy, because of immunological variation between

14600: 11701: 7825: 2079:

Advance Development and use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria

2065:

maintain the efficacy of antibiotics already on the market; and to help to develop future diagnostics, antibiotics, and vaccines.

1655:, has helped to control this problem, but new drugs are needed because of the continuing emergence of drug-resistant HIV strains. 1423:. They were responsible for 929,000 deaths attributable to resistance and 3.57 million deaths associated with resistance in 2019. 591:

Antibiotics are fed to livestock to act as growth supplements, and a preventive measure to decrease the likelihood of infections.

269:, priorities changed, and action against AMR slowed because scientific and government focus moved to the more pressing problem of 16579: 7987: 7927: 5348: 2649: 2387:

are the first agents to be used in this manner and the scheme is potential blueprint for comparable programs in other countries.

2148:

have been placed on an agar plate growing bacteria. Bacteria are not able to grow around antibiotics to which they are sensitive.

1113: 13837: 5213:"Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing" 18250: 18237: 16851: 16607: 15765: 15727: 15007: 14893: 14424: 14165: 14108: 14051: 13946: 13725: 13570: 13460: 13137: 12867: 12752: 12430: 12210: 12099: 11993: 11930: 11124: 10267: 10179:"Carbapenemase genes and genetic platforms in Gram-negative bacilli: Enterobacteriaceae, Pseudomonas and Acinetobacter species" 9892: 8215:"Effects of In-Feed Chlortetracycline Prophylaxis in Beef Cattle on Animal Health and Antimicrobial-Resistant Escherichia coli" 7697: 7534: 7294: 6933: 6778: 6680: 6615: 6534: 6220: 5993: 5611: 5508: 5305:

Blaser MJ, Melby MK, Lock M, Nichter M (February 2021). "Accounting for variation in and overuse of antibiotics among humans".

5260: 5064: 4912: 4566: 4378: 4184: 3932: 3812: 1065: 577: 47: 170:. However, extended use of antibiotics appears to encourage selection for mutations which can render antibiotics ineffective. 17522: 15081: 15055: 14594: 13960: 11463: 11294: 10717: 9261: 8870: 7761: 5530: 3726: 3255: 3119: 2541: 2497:. Phage therapy has many potential applications in human medicine as well as dentistry, veterinary science, and agriculture. 1274: 688:

inside the permafrost, and it is possible for microorganisms to resume their life functions once it thaws. While some common

16864: 8979: 6886:"Exploring Models for an International Legal Agreement on the Global Antimicrobial Commons: Lessons from Climate Agreements" 6404:. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, pp. 1211–1362, doi:10.1017/9781009157896.011. 3885:"Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance" 2096:

Reduction of inappropriate antibiotic prescription and use by at least 50% in outpatient settings and 20% inpatient settings

1516:

Antibiotic resistance can be introduced artificially into a microorganism through laboratory protocols, sometimes used as a

1513:, which are particles produced by the host cell that resemble bacteriophage structures and are capable of transferring DNA. 434:

that naturally produces antibiotics. Also, many soil fungi and bacteria are natural competitors and the original antibiotic

18039: 17497: 15857: 15822: 15539: 14328:"Antibiotic resistome from the One-Health perspective: understanding and controlling antimicrobial resistance transmission" 13313: 9682: 9589: 6367: 6173:"Population genomics confirms acquisition of drug-resistant Aspergillus fumigatus infection by humans from the environment" 5832: 4863:"Do fluoroquinolones increase aortic aneurysm or dissection incidence and mortality? A systematic review and meta-analysis" 3081: 2566: 1404:

A number of mechanisms used by common antibiotics to deal with bacteria and ways by which bacteria become resistant to them

1227: 17: 12937:

Singh G, Rana A (May 2024). "Decoding antimicrobial resistance: unraveling molecular mechanisms and targeted strategies".

8186: 4230:"The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis" 17176: 15565: 14527: 8685: 1854:

are used to treat infections. These drugs are effective but infections caused by resistant parasites have been reported.

13785: 13486: 9077: 5914: 2405:

has shown to effectively inhibit the bacterial growth of up to 50 clinically relevant bacteria including MRSA and MRSE.

1452:

Some bacteria are naturally resistant to certain antibiotics; for example, gram-negative bacteria are resistant to most

1149:

improve awareness and understanding of antimicrobial resistance through effective communication, education and training.

18242: 16551: 13815: 13661: 8543: 7187: 6239:"Dual use of antifungals in medicine and agriculture: How do we help prevent resistance developing in human pathogens?" 5171: 2581: 2050: 1557: 17246: 14854:"Safety analysis of a Russian phage cocktail: from metagenomic analysis to oral application in healthy human subjects" 9107: 8876: 8837: 8722: 5380:"The Use of Antibiotics and Antimicrobial Resistance in Veterinary Medicine, a Complex Phenomenon: A Narrative Review" 18332: 17672: 17667: 11821:

President's 2016 Budget Proposes Historic Investment to Combat Antibiotic-Resistant Bacteria to Protect Public Health

9841:

von Wintersdorff CJ, Penders J, van Niekerk JM, Mills ND, Majumder S, van Alphen LB, et al. (19 February 2016).

9611:

Robicsek A, Jacoby GA, Hooper DC (October 2006). "The worldwide emergence of plasmid-mediated quinolone resistance".

8458:

Bengtsson B, Wierup M (2006). "Antimicrobial resistance in Scandinavia after ban of antimicrobial growth promoters".

2317: 2035: 897: 832: 17277: 16105: 3972: 1716:-resistant Candida species and azole resistance in Aspergillus fumigatus have been highlighted as a growing threat. 1705:

concern, driven by multiple extrinsic factors, including extensive fungicidal use, overuse of clinical antifungals,

474:

73% of the population resorted to treating their minor health issues and chronic illnesses through self-medication.

18211: 17751: 17158: 16774: 16541: 12163:"Machine Learning for Antimicrobial Resistance Prediction: Current Practice, Limitations, and Clinical Perspective" 11549: 8187:

Water, sanitation and hygiene in health care facilities – Status in low and middle income countries and way forward

7130: 3570: 2576: 1501:

uptaking of naked fragments of extracellular DNA that contain antibiotic resistance genes to streptomycin, through

1124:

use in poultry production because of substantial evidence linking it to the emergence of fluoroquinolone-resistant

13618:

Nordrum A (2015). "Antibiotic Resistance: Why Aren't Drug Companies Developing New Medicines to Stop Superbugs?".

9140: 8930:"Antibiotic prescribing in primary care, adherence to guidelines and unnecessary prescribing—an Irish perspective" 5429: 18347: 17345: 16481: 15974: 13994:"Rational prioritization strategy allows the design of macrolide derivatives that overcome antibiotic resistance" 12226:"Molecular diagnostics for genotypic detection of antibiotic resistance: current landscape and future directions" 10944:"Trypanosoma cruzi, the Causal Agent of Chagas Disease: Boundaries between Wild and Domestic Cycles in Venezuela" 6390: 2349: 1071: 1053: 533:

about the effectiveness and necessity of antibiotics to treat common mild illnesses contribute to their overuse.

15537:

Bracing for Superbugs: Strengthening environmental action in the One Health response to antimicrobial resistance

13747: 12542:

Mishra RP, Oviedo-Orta E, Prachi P, Rappuoli R, Bagnoli F (October 2012). "Vaccines and antibiotic resistance".

4228:

Mestrovic T, Robles Aguilar G, Swetschinski LR, Ikuta KS, Gray AP, Davis Weaver N, et al. (November 2022).

230:

Antibiotic resistance is increasing globally due to increased prescribing and dispensing of antibiotic drugs in

18086: 17684: 17403: 17381: 16812: 16536: 16232: 16143: 16009: 15691: 15558: 13634: 10571:

Xie JL, Polvi EJ, Shekhar-Guturja T, Cowen LE (2014). "Elucidating drug resistance in human fungal pathogens".

10155: 9743: 6090: 4395: 2039: 1026: 218:

and disinfecting between patients, and should encourage the same of every patient, visitor, and family member.

11170: 8009: 6237:

Verweij PE, Arendrup MC, Alastruey-Izquierdo A, Gold JA, Lockhart SR, Chiller T, et al. (December 2022).

6012:"External Societal Costs of Antimicrobial Resistance in Humans Attributable to Antimicrobial Use in Livestock" 2461:, this allows the identification of all the antimicrobial resistance genes within the sample – the so-called " 1950:

The phenomenon of antimicrobial resistance caused by overuse of antibiotics was predicted as early as 1945 by

1366:

in bacteria inhibited by sulfonamides, instead, like mammalian cells, they turn to using preformed folic acid.

18337: 18054: 16752: 16461: 16086: 9706:"Compensatory mutations, antibiotic resistance and the population genetics of adaptive evolution in bacteria" 8540:"GAO-11-801, Antibiotic Resistance: Agencies Have Made Limited Progress Addressing Antibiotic Use in Animals" 1889: 1030: 417:

A CDC infographic on how antibiotic resistance (a major type of antimicrobial resistance) happens and spreads

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Baylay AJ, Piddock LJ, Webber MA (14 March 2019). "Molecular Mechanisms of Antibiotic Resistance – Part I".

7762:"A systematic review to explore influences on parental attitudes towards antibiotic prescribing in children" 4685: 18352: 18081: 17234: 16997: 16712: 16014: 9475:"NorM, a putative multidrug efflux protein, of Vibrio parahaemolyticus and its homolog in Escherichia coli" 8045:

Reduce unintentional exposure and the need for antimicrobials, and optimize their use IACG Discussion Paper

2955:

Ikuta KS, Swetschinski LR, Robles Aguilar G, Sharara F, Mestrovic T, Gray AP, et al. (December 2022).

2906:

Fisher MC, Alastruey-Izquierdo A, Berman J, Bicanic T, Bignell EM, Bowyer P, et al. (September 2022).

2379:(NICE) whereby an annual subscription fee is paid for use of strategically valuable antimicrobial agents – 2364: 2082:

Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines

1117: 1082:, currently there is no regulation on the use of similar antifungal classes in agriculture and the clinic. 868:

By comparison there is a lack of national and international monitoring programs for antifungal resistance.

16906: 12685: 9957:"Whole-genome sequencing and antimicrobial resistance in Brucella melitensis from a Norwegian perspective" 7463: 6884:

Rogers Van Katwyk S, Giubilini A, Kirchhelle C, Weldon I, Harrison M, McLean A, et al. (March 2023).

5461:"Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings" 3883:

Rodríguez-Baño J, Rossolini GM, Schultsz C, Tacconelli E, Murthy S, Ohmagari N, et al. (March 2021).

1824:

has also been reported. The problem of drug resistance in malaria has driven efforts to develop vaccines.

1155:

reduce the incidence of infection through effective sanitation, hygiene and infection prevention measures.

18123: 17994: 17930: 17898: 17846: 17143: 17125: 16204: 15717: 7856: 7408:"Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem" 4105: 2368: 2102:

Elimination of the use of medically important antibiotics for growth promotion in food-producing animals.

1868: 1486: 11844:"FACT SHEET: Obama Administration Releases National Action Plan to Combat Antibiotic-Resistant Bacteria" 8906: 8375:"The European ban on growth-promoting antibiotics and emerging consequences for human and animal health" 1737:

yeasts normally inhabit the skin and mucous membranes without causing infection. However, overgrowth of

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There are multiple national and international monitoring programs for drug-resistant threats, including

445:

Antimicrobial resistance can be acquired from other microbes through swapping genes in a process termed

178:. Extended use of antifungals leads to development of antifungal resistance through various mechanisms. 18290: 17679: 17092: 16832: 15939: 15758: 14446: 11316: 10283:"Resistance determinants and mobile genetic elements of an NDM-1-encoding Klebsiella pneumoniae strain" 8118: 4509:

Larsen J, Raisen CL, Ba X, Sadgrove NJ, Padilla-González GF, Simmonds MS, et al. (February 2022).

4086:"WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health" 1339: 1284: 1190: 908: 198: 13088:

Imamovic L, Ellabaan MM, Dantas Machado AM, Citterio L, Wulff T, Molin S, et al. (January 2018).

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Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. (September 2010).

8078: 4678:"Global Database for Tracking Antimicrobial Resistance (AMR) Country Self- Assessment Survey (TrACSS)" 4135:

Cassini A, Högberg LD, Plachouras D, Quattrocchi A, Hoxha A, Simonsen GS, et al. (January 2019).

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Two registrational trials have evaluated vaccine candidates in active immunization strategies against

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12495:"Rapid viral diagnosis for acute febrile respiratory illness in children in the Emergency Department" 9705: 8079:"The Impact of Water and Sanitation on Diarrhoeal Disease Burden and Over-Consumption of Anitbiotics" 6629:

Alempic JM, Lartigue A, Goncharov AE, Grosse G, Strauss J, Tikhonov AN, et al. (February 2023).

3247: 2546: 2360: 2333: 2112: 1494: 927: 912: 888: 767:

of thawed ground above them, which may mean that this risk is "no greater" than from any other soil.

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have failed to survive intentional attempts to revive them, more cold-adapted microorganisms such as

616: 291: 239: 202: 12628:"Why the evolution of vaccine resistance is less of a concern than the evolution of drug resistance" 12161:

Kim JI, Maguire F, Tsang KK, Gouliouris T, Peacock SJ, McAllister TA, et al. (September 2022).

11067:"Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance" 9843:"Dissemination of Antimicrobial Resistance in Microbial Ecosystems through Horizontal Gene Transfer" 5211:

Rawson TM, Moore LS, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. (December 2020).

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Dabour R, Meirson T, Samson AO (December 2016). "Global antibiotic resistance is mostly periodic".

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of AMR resistances in the food chain pipeline may have far-reaching implications for human health.

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Gallagher JC, Justo JA, Chahine EB, Bookstaver PB, Scheetz M, Suda KJ, et al. (August 2018).

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McCallin S, Alam Sarker S, Barretto C, Sultana S, Berger B, Huq S, et al. (September 2013).

13090:"Drug-Driven Phenotypic Convergence Supports Rational Treatment Strategies of Chronic Infections" 12040:

van Belkum A, Bachmann TT, Lüdke G, Lisby JG, Kahlmeter G, Mohess A, et al. (January 2019).

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Visser BJ, van Vugt M, Grobusch MP (October 2014). "Malaria: an update on current chemotherapy".

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5025:"Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010–2011" 4582:"Good microbes, bad genes? The dissemination of antimicrobial resistance in the human microbiome" 4199:"Antibiotic-resistant bacteria responsible for over 33,000 deaths in Europe in 2015, study finds" 2551: 2519: 1876: 1831: 1679: 1502: 839: 720: 318:

In 2018, WHO considered antibiotic resistance to be one of the biggest threats to global health,

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Hopkins H, Bruxvoort KJ, Cairns ME, Chandler CI, Leurent B, Ansah EK, et al. (March 2017).

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Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, et al. (November 2017).

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Lucien MA, Canarie MF, Kilgore PE, Jean-Denis G, Fénélon N, Pierre M, et al. (March 2021).

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Gerber JS, Ross RK, Bryan M, Localio AR, Szymczak JE, Wasserman R, et al. (December 2017).

1505:, as in the bacteriophage-mediated transfer of tetracycline resistance genes between strains of 1445:, protecting it from the action of quinolones. Finally, mutations at key sites in DNA gyrase or 931:

the length of stay by an average of slightly over 1 day while not increasing the risk of death.

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In 89% of countries, antibiotics can only be prescribed by a doctor and supplied by a pharmacy.

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Sansom C (March 2017). "Media Watch: An intimate family story in a world without antibiotics".

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Legendre M, Lartigue A, Bertaux L, Jeudy S, Bartoli J, Lescot M, et al. (September 2015).

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Lobie TA, Roba AA, Booth JA, Kristiansen KI, Aseffa A, Skarstad K, et al. (October 2021).

4812:"The threat of antimicrobial resistance in developing countries: causes and control strategies" 4309:

Holmes AH, Moore LS, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, et al. (January 2016).

3485:

Dramé O, Leclair D, Parmley EJ, Deckert A, Ouattara B, Daignault D, et al. (August 2020).

3286: 2160: 2141: 1838:(American trypanosomiasis). There are no vaccines to prevent these infections so drugs such as 1630: 1622: 1572: 1438: 1417:

Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii

1370: 1355: 1206: 1186: 883: 13899:"The Antifungal Pipeline: Fosmanogepix, Ibrexafungerp, Olorofim, Opelconazole, and Rezafungin" 13897:

Hoenigl M, Sprute R, Egger M, Arastehfar A, Cornely OA, Krause R, et al. (October 2021).

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Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM, et al. (May 2016).

3763:

Hoffman SJ, Outterson K, Røttingen JA, Cars O, Clift C, Rizvi Z, et al. (February 2015).

1892:, finding large regional variations, providing maps, and suggesting resistance genes are also 1453: 18096: 17728: 17597: 17105: 17012: 16931: 16511: 16303: 15782: 15751: 15001: 14887: 14418: 14159: 14102: 14045: 13940: 13719: 13660:

Schmitt S, Montalbán-López M, Peterhoff D, Deng J, Wagner R, Held M, et al. (May 2019).

13564: 13454: 13131: 12861: 12746: 12424: 12204: 12093: 11987: 11924: 11256: 11118: 10261: 9886: 7691: 7528: 7288: 7247:"Preventing the Post-Antibiotic Era by Training Future Pharmacists as Antimicrobial Stewards" 6927: 6772: 6674: 6609: 6528: 6214: 6027: 5987: 5605: 5502: 5254: 5058: 4906: 4560: 4372: 4178: 3926: 3806: 3316: 2402: 2384: 2169: 1913: 1685: 1648: 1581: 1568: 1490: 1374: 1210: 1202: 1141: 546: 545:

Increased antibiotic use during the early waves of the COVID-19 pandemic may exacerbate this

530: 197:, which can lead to antibiotic resistance, includes taking antibiotics only when prescribed. 16876: 14676:

Salmond GP, Fineran PC (December 2015). "A century of the phage: past, present and future".

13409:

Alene KA, Wangdi K, Colquhoun S, Chani K, Islam T, Rahevar K, et al. (September 2021).

12383:"Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections" 10071:

cells grown in simulated microgravity for an extended period is both phenotypic and genomic"

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Manufacturers of antimicrobials need to improve the treatment of their wastewater (by using

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Knight GM, Davies NG, Colijn C, Coll F, Donker T, Gifford DR, et al. (November 2019).

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Tirumalai MR, Karouia F, Tran Q, Stepanov VG, Bruce RJ, Ott M, et al. (January 2019).

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mathematical modelling can be used to anticipate the likely effects of different policies.

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carrying antibiotic resistance genes between bacteria of the same or different species via

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Antimicrobial resistance can evolve naturally due to continued exposure to antimicrobials.

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König G, Sokkar P, Pryk N, Heinrich S, Möller D, Cimicata G, et al. (November 2021).

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WHO fungal priority pathogens list to guide research, development and public health action

7648:

Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, et al. (February 2017).

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Rhodes J, Abdolrasouli A, Dunne K, Sewell TR, Zhang Y, Ballard E, et al. (May 2022).

5276:"Rutgers study finds antibiotic overuse is caused by misconceptions, financial incentives" 3657: 8: 18265: 18255: 18221: 17826: 17264: 17100: 16911: 16456: 16344: 16313: 15959: 15919: 15842: 15696: 15151: 6475:

Ng TF, Chen LF, Zhou Y, Shapiro B, Stiller M, Heintzman PD, et al. (November 2014).

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in order to isolate bacteria with altered phenotype directly from the analytical matrix.

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Ribosome splitting and recycling: for example, drug-mediated stalling of the ribosome by

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CDC Guideline "Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006"

14009: 13547: 13528: 13512: 12997: 12982:"Alternating antibiotic treatments constrain evolutionary paths to multidrug resistance" 12950: 12643: 12290: 12275:"Antibiotic susceptibility testing in less than 30 min using direct single-cell imaging" 12129: 11200: 11082: 10707: 10298: 9972: 9539: 8230: 8111:"Goal 6: Ensure availability and sustainable management of water and sanitation for all" 7375: 7350: 7068: 7041: 6910: 6885: 6852: 6805: 6740: 6565: 6492: 6316: 6265: 6238: 6133: 5642: 5406: 5379: 4526: 3843: 3241: 2017:

Please help update this article to reflect recent events or newly available information.

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antifungal resistance could rely on the development of host-directed therapies such as

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can decrease their binding affinity to quinolones, decreasing the drug's effectiveness.

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developed a resistance to penicillin in 1976. Another example is Azithromycin-resistant

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had no toilets and 35% had no water and soap or alcohol-based hand rub for handwashing.

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Tirumalai MR, Karouia F, Tran Q, Stepanov VG, Bruce RJ, Ott M, et al. (May 2017).

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exposed to long-term low-shear modeled microgravity and background antibiotic exposure"

10013: 9989: 9956: 9932: 9907: 9869: 9842: 9730: 9558: 9523: 9473:

Morita Y, Kodama K, Shiota S, Mine T, Kataoka A, Mizushima T, et al. (July 1998).

9409: 9384: 9267: 9221: 9196: 8956: 8929: 8483: 8350: 8325: 8301: 8274: 8247: 8214: 8165: 8153: 7881: 7792: 7737: 7712: 7674: 7649: 7625: 7600: 7576: 7549: 7511: 7486: 7432: 7407: 7388: 7271: 7246: 6973: 6948: 6866: 6817: 6760: 6657: 6630: 6592: 6579: 6549: 6511: 6476: 6335: 6300: 6278: 6197: 6172: 6153: 6036: 6011: 5970: 5945: 5891: 5867:"Antibiotics Overuse in Animal Agriculture: A Call to Action for Health Care Providers" 5866: 5808: 5781: 5721: 5708: 5683: 5664: 5593: 5580: 5553: 5485: 5460: 5330: 5237: 5212: 5152: 5104: 5079: 5000: 4983: 4954: 4927: 4889: 4862: 4838: 4811: 4792: 4740: 4716:"Self-medication and antibiotic resistance: Crisis, current challenges, and prevention" 4715: 4659: 4606: 4581: 4543: 4510: 4456: 4429: 4348: 4262: 4229: 4161: 4136: 3964: 3909: 3884: 3865: 3789: 3764: 3634: 3607: 3515: 3486: 3431: 3404: 3380: 3353: 3215: 3190: 3166:. National Prescribing Service Limited trading, Australia. 13 June 2013. Archived from 3052: 3039: 3014: 2981: 2956: 2932: 2907: 2801: 2774: 2745: 2718: 2641: 2211: 2198: 2164: 2073:

Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections

1761: 1460:. Antibiotic resistance can also be acquired as a result of either genetic mutation or 1408:

There are several different types of germs that have developed a resistance over time.

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also have lower prescribing rates, with Sweden's rate having been declining since 2007.

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resistance. Together all of these come under the umbrella of antimicrobial resistance.

16921: 15368: 15192: 14781: 13218: 13201: 13168: 11354:"A brief history of the antibiotic era: lessons learned and challenges for the future" 10235: 9624: 9499: 9474: 9360: 9335: 9311: 9286: 7979: 7919: 7223: 5961: 5757: 5740: 4326: 4245: 4152: 3352:

Gullberg E, Cao S, Berg OG, Ilbäck C, Sandegren L, Hughes D, et al. (July 2011).

3030: 2972: 2775:"Review on Multiple Facets of Drug Resistance: A Rising Challenge in the 21st Century" 2276:

resistant bacteria emerge in vitro relative to a single drug for the entire duration.

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in 2024. Recently, this platform has been advanced by coupling microfluidic chip with

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Establishment of State Antibiotic Resistance (AR) Prevention Programs in all 50 states

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React based in Sweden has produced informative material on AMR for the general public.

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with weaker healthcare systems are more affected, with mortality being the highest in

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Public calls for global collective action to address the threat include proposals for

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McNeely TB, Shah NA, Fridman A, Joshi A, Hartzel JS, Keshari RS, et al. (2014).

12800: 12734: 12713:"Use of a Staphylococcus aureus conjugate vaccine in patients receiving hemodialysis" 12667: 12608: 12559: 12524: 12475: 12412: 12363: 12314: 12255: 12192: 12143: 12081: 11975: 11912: 11881:"Mathematical modelling for antibiotic resistance control policy: do we know enough?" 11776: 11721: 11674: 11636: 11469: 11459: 11434: 11385: 11106: 11027: 10975: 10924: 10873: 10814: 10779: 10713: 10688: 10637: 10588: 10553: 10504: 10469: 10420: 10371: 10322: 10249: 10200: 10139: 10100: 10047: 9994: 9937: 9874: 9823: 9782: 9735: 9674: 9628: 9563: 9504: 9455: 9450: 9433: 9414: 9400: 9365: 9316: 9302: 9271: 9257: 9226: 8961: 8866: 8858: 8652: 8588: 8521: 8475: 8437: 8396: 8355: 8306: 8252: 8197: 8157: 7886: 7784: 7742: 7679: 7630: 7581: 7516: 7437: 7380: 7331: 7326: 7309: 7276: 7227: 7073: 7022: 6978: 6915: 6870: 6821: 6764: 6752: 6662: 6597: 6516: 6477:"Preservation of viral genomes in 700-y-old caribou feces from a subarctic ice patch" 6340: 6282: 6270: 6202: 6145: 6041: 6010:

Innes GK, Randad PR, Korinek A, Davis MF, Price LB, So AD, et al. (April 2020).

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Swedish work on containment of antibiotic resistance – Tools, methods and experiences

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In one study, which has implications for space microbiology, a non-pathogenic strain

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Parfitt T (June 2005). "Georgia: an unlikely stronghold for bacteriophage therapy".

14151: 14094: 13696: 11788: 11733: 11231:"Patients contracted 165 antibiotic resistant infections each day in 2018, says PHE" 10826: 10657:"MFS multidrug transporters in pathogenic fungi: do they have real clinical impact?" 10151: 8487: 7392: 6748: 6157: 6141: 5156: 4796: 4663: 3015:"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis" 1636:

Antiviral drugs typically target key components of viral reproduction; for example,

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Videos are being produced for the general public to generate interest and awareness.

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infection were five times more likely to die than control recipients who developed

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infections were reported for 4 out of 6 types of healthcare associated infections.

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Leonard C, Crabb N, Glover D, Cooper S, Bouvy J, Wobbe M, et al. (May 2023).

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and cystic fibrosis can cause respiratory disorders, deafness and kidney failure.

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have pledged money for developing strategies to counter antimicrobial resistance.

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The five main mechanisms by which bacteria exhibit resistance to antibiotics are:

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to antibiotics and other antimicrobial medicines was endorsed at the Sixty-eighth

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people who need them to treat infections—is now a major threat to public health."

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Ghaith DM, Mohamed ZK, Farahat MG, Aboulkasem Shahin W, Mohamed HO (March 2019).

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Chen C, Patterson B, Simpson R, Li Y, Chen Z, Lv Q, et al. (9 August 2022).

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compliance by hospital staff results in decreased rates of resistant organisms.

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ResistanceOpen is an online global map of antimicrobial resistance developed by

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