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Tackling Threats and Future Problems of Multidrug-Resistant Bacteria

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How to Overcome the Antibiotic Crisis

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 398))

Abstract

With the advent of the antibiotic era, the overuse and inappropriate consumption and application of antibiotics have driven the rapid emergence of multidrug-resistant pathogens. Antimicrobial resistance increases the morbidity, mortality, length of hospitalization and healthcare costs. Among Gram-positive bacteria, Staphylococcus aureus (MRSA) and multidrug-resistant (MDR) Mycobacterium tuberculosis, and among the Gram-negative bacteria, extended-spectrum beta-lactamase (ESBLs)-producing bacteria have become a major global healthcare problem in the 21st century. The pressure to use antibiotics guarantees that the spread and prevalence of these as well as of future emerging multidrug-resistant pathogens will be a persistent phenomenon. The unfeasibility of reversing antimicrobial resistance back towards susceptibility and the critical need to treat bacterial infection in modern medicine have burdened researchers and pharmaceutical companies to develop new antimicrobials effective against these difficult-to-treat multidrug-resistant pathogens. However, it can be anticipated that antibiotic resistance will continue to develop more rapidly than new agents to treat these infections become available and a better understanding of the molecular, evolutionary and ecological mechanisms governing the spread of antibiotic resistance is needed. The only way to curb the current crisis of antimicrobial resistance will be to develop entirely novel strategies to fight these pathogens such as combining antimicrobial drugs with other agents that counteract and obstruct the antibiotic resistant mechanisms expressed by the pathogen. Furthermore, as many antibiotics are often inappropriately prescribed, a more personalized approach based on precise diagnosis tools will ensure that proper treatments can be promptly applied leading to more targeted and effective therapies. However, in more general terms, also the overall use and release of antibiotics in the environment needs to be better controlled.

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Abbreviations

CA-MRSA:

Community-acquired methicillin-resistant Staphylococcus aureus

CDC:

Center for Disease Control and Prevention

CRE:

Carbapenem-resistant Enterobacteriacea

DOTS:

Direct Observed Treatment Short-Course

ESBL:

Extended spectrum β-lactamase

ESKAPE:

Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.

FDA:

Food and Drug Administration

H-MRSA:

Hospital-acquired methicillin-resistant Staphylococcus aureus

hVISA:

Heterogeneous vancomycin-intermediate Staphylococcus aureus

IDSA:

Infectious Diseases Society of America

IMP:

Metallo-β-lactamase active on imipenem

KPC:

Klebsiella pneumoniae carbapenemases

LPS:

Lipopolysaccharide

MDR:

Multidrug-resistant

MDR-TB:

Multidrug-resistant tuberculosis

MIC:

Minimum inhibitory concentration

MRAB:

Multidrug-resistant Acinetobacter baumannii

MRSA:

Methicillin-resistant Staphylococcus aureus

MSSA:

Methicillin-susceptible Staphylococcus aureus

MYSTIC:

Meropenem Yearly Susceptibility Test Information Collection

NDM:

New Delhi β-lactamase

PBP2a:

Penicillin-binding protein 2a

PDR:

Pandrug-resistant

SIM:

Seoul imipenemase

SME:

Serratia marcescens enzyme

TDR-TB:

Totally drug-resistant tuberculosis

VIM:

Verona integron-encoded metallo-β-lactamase

VISA:

Vancomycin intermediate-resistant Staphylococcus aureus

VRSA:

Vancomycin-resistant Staphylococcus aureus

WHO:

World Health Organization

XDR:

Extensive drug resistant

XDR-TB:

Extensive drug resistant tuberculosis

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Authors and Affiliations

  1. Infection Immunology Research Group, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124, Braunschweig, Germany

    Eva Medina

  2. Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124, Braunschweig, Germany

    Dietmar Helmut Pieper

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  1. Eva Medina
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  2. Dietmar Helmut Pieper
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Correspondence to Eva Medina .

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Editors and Affiliations

  1. Department Microbial Drugs, Helmholtz Centre for Infection Research, Braunschweig, Niedersachsen, Germany

    Marc Stadler

  2. Dept. Molecular Infection Biology, Helmholtz Centre for Infection Research, Braunschweig, Niedersachsen, Germany

    Petra Dersch

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Medina, E., Pieper, D.H. (2016). Tackling Threats and Future Problems of Multidrug-Resistant Bacteria. In: Stadler, M., Dersch, P. (eds) How to Overcome the Antibiotic Crisis . Current Topics in Microbiology and Immunology, vol 398. Springer, Cham. https://doi.org/10.1007/82_2016_492

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