Ciba Foundation Symposium 207 - Antibiotic Resistance:

Antibiotic Resistance: Origins, Evolution, choice and unfold Chairman: Stuart B. Levy 1997 over the past 50 years, the quick elevate within the use of antibiotics, not just in humans, but in addition in animal husbandry and agriculture, has introduced a range extraordinary within the historical past of evolution. for that reason, society is dealing with one among its gravest public well-being problems-the emergence of infectious micro organism with resistance to many, and now and again all, on hand antibiotics. This booklet brings jointly a multidisciplinary crew of specialists to debate this challenge. It starts via analyzing the origins of resistance and is going directly to examine how using antibiotics in human medication and farming/agriculture has chosen for resistant micro organism. Separate chapters describe the evolution of resistance determinants and the way those are unfold either inside of and among bacterial species. ultimately, the e-book comprises discussions on techniques for countering the specter of antibiotic resistance. an immense re-thinking of our method of the remedy of infectious illnesses is proposed-that antibiotic resistance might be noticeable as an issue created via the disruption of ordinary microbial ecology. to revive efficacy to prior antibiotics, and to take care of the good fortune of recent antibiotics which are brought, we have to use those medicines in a manner that guarantees an ecological stability that favours the predominance of weak micro organism.

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Cohen: It would be interesting to understand the different frequencies in resistance mechanisms between Gram-positives and Gram-negatives. The 32 DISCUSSION organisms are trying to tell us something. Methicillin resistance in methicillinresistant S. aureus (MRSA) is a good example. We have many effective plactamases in the same environments as the MRSA, but changes in penicillin binding proteins remain the predominant mechanism of methicillin resistance. Roberts: Transformation may have some power in that.

As such this provides a very stable source of resistance genes. Lev: We are seeing changes which we can actually pinpoint to the antibiotic era. Marilyn Roberts has detected tetracycline resistance genes in Mycobucterium where they were never detected before (Roberts 1997, this volume). We see whole plasmids integrating into chromosomes. It seems there are certain events which we can document now. In some instances we can say that this event has occurred within the period of widespread antibiotic use.

They are real miracle drugs (Levy 1992). 36 ERYTHROMYCIN CONSUMPTION A N D RESISTANCE I N FINLAND 37 Antimicrobials have now been in use for more than 60 years. During this period a tremendous selection pressure has been exerted on human bacterial pathogens. If we look the history of antimicrobial agents, development of bacterial resistance against antimicrobial agents has been an expected but rather unpredictable phenomenon. Today, the worldwide increase of antimicrobial resistance poses a serious clinical problem (Neu 1992).

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