Article ; Online: The 2017 Garrod Lecture: Genes, guts and globalization.
The Journal of antimicrobial chemotherapy
2018 Volume 73, Issue 10, Page(s) 2589–2600
Abstract: ... as illustrated by the emergence and rapid spread of CTX-M β-lactamases and the carbapenemases. The unique ...
Abstract | The widespread use of antibacterial drugs over the last 70 years has brought immense benefits to human health at the price of increasing drug inefficacy. Antibacterial agents have a strong selective effect in both favouring resistant strains and allowing particular species and families of bacteria to prosper, especially in the healthcare setting. Whilst important Gram-positive bacterial pathogens such as Staphylococcus aureus and Streptococcus pneumoniae caused concern over the last 20 years because of the spread of antibiotic-resistant strains, Enterobacteriaceae have become the biggest challenge. They have very efficient mechanisms for genetic exchange, as illustrated by the emergence and rapid spread of CTX-M β-lactamases and the carbapenemases. The unique epidemiology of Enterobacteriaceae, with substantial numbers colonizing the mammalian gut and subsequent release into and spread in the environment, presents a significant threat to human health because of the high levels of exposure for the whole community. The use of antimicrobials in agriculture combined with global movements of people, animals and food, arising from worldwide industrialization, generates a diversity and level of resistance not seen previously. Control will require globally coordinated interventions similar to those needed to ameliorate climate change. |
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MeSH term(s) | Animals ; Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Drug Resistance, Multiple, Bacterial/genetics ; Enterobacteriaceae/drug effects ; Enterobacteriaceae Infections/drug therapy ; Enterobacteriaceae Infections/epidemiology ; Enterobacteriaceae Infections/prevention & control ; Gram-Positive Bacteria/drug effects ; Humans ; Internationality ; Public Health ; beta-Lactamases/genetics |
Chemical Substances | Anti-Bacterial Agents ; Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6) |
Language | English |
Publishing date | 2018-07-03 |
Publishing country | England |
Document type | Journal Article ; Lecture |
ZDB-ID | 191709-2 |
ISSN | 1460-2091 ; 0305-7453 |
ISSN (online) | 1460-2091 |
ISSN | 0305-7453 |
DOI | 10.1093/jac/dky277 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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