An Overview of Antibiotic Resistance
Antibiotics are commonly prescribed drugs that kill bacteria or suppress their ability to grow, allowing the human immune system to respond and heal from illness. Antibiotic resistance is a dangerous bacterial trait which enables bacteria to survive and continue to grow instead of being inhibited or destroyed by therapeutic doses of the drug. As a result, antibiotic-resistant bacteria can evade the effects of the antibiotic and multiply, with severe consequences for human health. For example, some of the major bacterial causes of illness in the United States, including E. coli1,1 Salmonella, Campylobacter, Enterococcus2, Streptococcus3 and Staphylococcus4 are increasingly resistant to treatment with first-line antibiotics.
The trait for resistance to an antibiotic is a result of mutations in the genetic material of bacteria. These mutations can occur spontaneously, be inherited or simply be transmitted between bacteria, spreading very easily. Moreover, because a gene that provides resistance to one type of antibiotic is often located right next to another gene that provides resistance to a different type of antibiotic, the result is often multidrug resistance. The rise of multidrug resistance has been documented in a study of incoming patients to a Boston hospital from 1998 to 2003, which showed that the likelihood of multidrug resistance in E. coli increased from two to almost 20 percent during the study period.5
Repeated and improper use of antibiotics appears to be the main cause of the increase in antibiotic-resistant bacteria. In general, low doses of antibiotics for long durations are more likely to cause resistance.6 Antibiotic-resistant genes can also be acquired through our food supply: bacteria present in food-producing animals may be resistant, and humans can acquire these bacteria when they eat meat from these animals or do not use proper hygiene techniques during food preparation.7 Farm workers also are at risk of exposure to drug-resistant bacteria and can transfer resistant infections to the broader public if they become ill.8 Lastly, antibiotic-resistant bacteria can reach the human community through surface and groundwater that has been contaminated by farm animal waste.9
1 Lewis, J.S., et al. 2007. First report of the emergence of CTX-M-Type Extended-Spectrum-Lactamases (ESBLs) as the predominant ESBL isolated in a U.S. health care system. Antimicrobial Agents and Chemotherapy. 51(110:4015-4021.
2 Mellon, Margaret, Charles Benbrook, & Karen Lutz Benbrook. 2001. Hogging It! Estimates of Antimicrobial Abuse in Livestock. Cambridge, MA: Union of Concerned Scientists.
3 Albrich, W.C., D.L. Monnet, & S. Harbarth. 2004. Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes. Emerging Infectious Diseases. 10 (3): 514–517.
4 Klevens, R.M., et al. 2007. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. The Journal of the American Medical Association (JAMA). 298(15): 1763-1771.
5 Pop-Vicas, A.E. and E.M. D’Agata. 2005. The rising influx of multidrug-resistant gram-negative bacilli into a tertiary care hospital. Clinical Infectious Diseases, 40(12): 1792-8.
6 The Department of Health and Human Services; Center for Disease Control and Prevention; ―National Antimicrobial Resistance Monitoring System (NARMS) Frequently Asked Question about Antibiotic Resistance.
7 Ibid.
8 U.S. General Accounting Office (GAO). 2004. Report to Congressional Requesters No. 04-490, ―Antibiotic Resistance: Federal Agencies Need to Better Focus Efforts to Address Risk to Humans from Antibiotic Use in Animals.
9 Ibid.
10 Mellon, et al., 2001, Op cit.
11 Ibid.
12 Roberts, R.R., et al. 2009. Hospital and Societal Costs of Antimicrobial-Resistant Infections in a Chicago Teaching Hospital: Implications for Antibiotic Stewardship. Clinical Infectious Diseases 49:1175–84.
13 Klevens, et al., 2007, Op cit.
14 According to the CDC, there were an estimated 12,543 deaths in the U.S. from HIV/AIDS in 2005. Center for Disease Control and Prevention (CDC). 2005. National Vital Statistics Report, Vol. 56, No. 10. <www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf>.
15 Infectious Diseases Society of America (IDSA). 2004. Bad Bugs, No Drugs: As Antibiotic Discovery Stagnates…a Public Health Crisis Brews.
Senator Dianne Feinstein (D-CA) today introduced the Preventing Antibiotic Resistance Act, a bipartisan bill that would eliminate certain antibiotic-related practices that contribute to the rise of drug-resistant bacteria and endanger human health. The legislation is co-sponsored by Senators Susan Collins (R-ME), Kirsten Gillibrand (D-NY), Jack Reed (D-RI), Barbara Boxer (D-CA) and Maria Cantwell (D-WA).
More infoThis bibliography lists the latest published scientific and economic literature concerning the contribution of routine antibiotic use in food animals to the growing public health crisis of human antibiotic resistance. Research on how antibiotic use in food animal production contributes to the growing health crisis of antibiotic resistance dates back more than 30 years.
More infoPew Charitable Trusts today applauded Senators Kirsten Gillibrand (D-NY), Dianne Feinstein (D-CA), and Susan Collins (R-ME), for introducing the Antimicrobial Data Collection Act, which would require the U.S. Food and Drug Administration, or FDA, to report more information on the annual sales of antibiotics used among industrial farm animals. The bipartisan bill would also give the agency a deadline to finalize policies proposed last year to eliminate the use of antibiotics for growth promotion purposes in meat production.
More info"As a nation, we need to exercise greater care with our use of antibiotics, in both humans and animals, so that these medications remain effective in treating serious bacterial infections."
More infoCopyright(c) 1996-2012 The Pew Charitable Trusts. All Rights Reserved.
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