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One organism, Methicillin-resistant Staphylococcus aureus (MRSA), kills approximately 19,000 Americans annually, which is more than HIV / AIDS, Parkinson's disease, emphysema, and homicide combined (5). In the mid-1980s, the incidence of MRSA isolates was close to zero, and by 1998 the incidence of MRSA was approximately 70% in Japan, 40% in Belgium, 30% in the United Kingdom, and 28% in the United States (1). Every year, 2 million Americans obtain hospital-acquired infections, most of which are caused by antibiotic resistant microorganisms, and result in 99,000 deaths (5). In malaria-endemic countries, resistance to earlier anti-malaria medications such as chloroquine and sulfadoxine-pyrimethamine is widespread, which sustains malaria as a significant health threat (2). Antibiotic resistance is relevant in every country, and has the potential to affect all strands of bacteria that are responsible for human infection.
Threat of Antibiotic Resistance
The prevalence of antibiotic resistant bacteria is not only a threat to global health, but also poses dangers for health expenditures, trade, and economy. In 2002, the cost of health care expenditures caused by antibiotic resistant microbes in the United States was estimated at $7 billion (1). Antibiotic resistance not only proves fatal to many patients, but it inhibits the control of infection diseases. This reduces the effectiveness of antibiotic treatments, causing patients to need medical care longer, and increases the risk of antibiotic resistant bacteria spreading to other patients. The WHO explains antibiotic resistance threatens to return global health to the pre-antibiotic era as many infectious diseases have the potential to become uncontrollable (2). Since conventional antibiotics can not be used on resistant bacteria, more expensive treatments are required, again causing longer hospital stays, and escalates the cost of healthcare. Growing costs of healthcare can weaken economies, both domestic and global. As antibiotic resistant bacteria continue to spread, and treatments become less effective, the growth of global trade and travel only intensifies the problem by allowing bacteria to travel the globe faster (2). Combating the threat of antibiotic resistant bacteria requires rational use of antibiotics, infection prevention and control, and patient safety at the very least.
The discovery of antibiotics, well over half a century ago, fundamentally transformed the way physicians treated patients as antibiotic drugs became the standard for medical intervention. Decades later, and in the wake of excessive antibiotic use and misuse, microorganisms have evolved in order to adapt to harsh environments created by antibiotic drugs, and are able to resist the effects of these drugs (5). Bacteria can resist antibiotics by altering their biochemistry, and gain resistance by receiving copies of resistance genes from other bacteria (3). Antibiotic resistant bacteria do not discriminate between the First World and Third World, and has impacted numerous countries and compromised the treatment of such diseases as MDR-TB, MRSA, and malaria. The growing prevalence of antibiotic resistance bacteria affects global health, healthcare expenditures, trade, and economy, and is not to be underestimated as a threat to global livelihood.
Personally, the one portion of the research that I found to be the most interesting was the prevalence of antibiotic resistant bacteria around the world. I knew that antibiotic resistance existed and was a medical concern, but I was not fully aware of how it exists on such a large scale. The numbers of MDR-TB reports alone is more than intimidating. I was overwhelmed by the thought of how many people go to their family practitioner for a cold and expect to receive antibiotics, and how this seemingly simple exchange between doctor and patient has led to these global health implications.
1. Smith, R, and J. Coast. "Antimicrobial resistance: a global response." Bulletin of the World Health Organization. 80.2 (2002): 126-133. Web. 29 Mar. 2012.
2. "Antimicrobial Resistance ." World Health Organization. WHO, Mar 2012. Web. 29 Mar 2012.
3. "How Antibiotic Resistance Happens." Save Antibiotics. The Pew Campaign on Human Health and Industrial Farming. Web. 29 Mar 2012.
4. "Gene Transfer Facilitates the Spread of Drug Resistance" Save Antibiotics. The Pew Campaign on Human Health and Industrial Farming. Web. 29 Mar 2012.
5. Spellberg, B. "Combating Antimicrobial Resistance: Policy Recommendations to Save Lives." Clinical Infectious Diseases.…[continue]
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