Antimicrobial resistance and diff antibiotic and microbial

Antimicrobial resistance

 http://www.who.int/mediacentre/factsheets/fs194/en/

Antimicrobial resistance

Fact sheet N°194
Updated April 2015

Key facts

• Antimicrobial resistance threatens the effective prevention and
  treatment of an ever-increasing range of infections caused by bacteria,
  parasites, viruses and fungi.
• It is an increasingly serious threat to global public health that requires action across all government sectors and society.
• Antimicrobial resistance is present in all parts of the world. New resistance mechanisms emerge and spread globally.
• In 2012, WHO reported a gradual increase in resistance to HIV
  drugs, albeit not reaching critical levels. Since then, further
  increases in resistance to first-line treatment drugs were reported,
  which might require using more expensive drugs in the near future.
• In 2013, there were about 480 000 new cases of
  multidrug-resistant tuberculosis (MDR-TB). Extensively drug-resistant
  tuberculosis (XDR-TB) has been identified in 100 countries. MDR-TB
  requires treatment courses that are much longer and less effective than
  those for non-resistant TB.
• In parts of the Greater Mekong subregion, resistance to the best
  available treatment for falciparum malaria, artemisinin-based
  combination therapies (ACTs), has been detected. Spread or emergence of
  multidrug resistance, including resistance to ACTs, in other regions
  could jeopardize important recent gains in control of the disease.
• There are high proportions of antibiotic resistance in bacteria
  that cause common infections (e.g. urinary tract infections, pneumonia,
  bloodstream infections) in all regions of the world. A high percentage
  of hospital-acquired infections are caused by highly resistant bacteria
  such as methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Gram-negative bacteria.
• Treatment failures due to resistance to treatments of last resort
  for gonorrhoea (third-generation cephalosporins) have been reported
  from 10 countries. Gonorrhoea may soon become untreatable as no vaccines
  or new drugs are in development.
• Patients with infections caused by drug-resistant bacteria are
  generally at increased risk of worse clinical outcomes and death, and
  consume more health-care resources than patients infected with the same
  bacteria that are not resistant.

What is antimicrobial resistance?

Antimicrobial resistance is resistance of a microorganism to
an antimicrobial drug that was originally effective for treatment of
infections caused by it.




Resistant microorganisms (including bacteria, fungi, viruses
and parasites) are able to withstand attack by antimicrobial drugs, such
as antibacterial drugs (e.g. antibiotics), antifungals, antivirals, and
antimalarials, so that standard treatments become ineffective and
infections persist, increasing the risk of spread to others.




The evolution of resistant strains is a natural phenomenon
that occurs when microorganisms replicate themselves erroneously or when
resistant traits are exchanged between them. The use and misuse of
antimicrobial drugs accelerates the emergence of drug-resistant strains.
Poor infection control practices, inadequate sanitary conditions and
inappropriate food-handling encourage the further spread of
antimicrobial resistance.

What is the difference between antibiotic and antimicrobial resistance?

Antibiotic resistance refers specifically to the resistance to
antibiotics that occurs in common bacteria that cause infections.
Antimicrobial resistance is a broader term, encompassing resistance to
drugs to treat infections caused by other microbes as well, such as
parasites (e.g. malaria), viruses (e.g. HIV) and fungi (e.g. Candida).

Why is antimicrobial resistance a global concern?

New resistance mechanisms emerge and spread globally
threatening our ability to treat common infectious diseases, resulting
in death and disability of individuals who until recently could continue
a normal course of life.





Without effective anti-infective treatment, many standard medical treatments will fail or turn into very high risk procedures.

Antimicrobial resistance kills

Infections caused by resistant microorganisms often fail to
respond to the standard treatment, resulting in prolonged illness,
higher health care expenditures, and a greater risk of death.




As an example, the death rate for patients with serious
infections caused by common bacteria treated in hospitals can be about
twice that of patients with infections caused by the same non-resistant
bacteria. For example, people with MRSA (methicillin-resistant Staphylococcus aureus,
another common source of severe infections in the community and in
hospitals) are estimated to be 64% more likely to die than people with a
non-resistant form of the infection.

Antimicrobial resistance hampers the control of infectious diseases

Antimicrobial resistance reduces the effectiveness of
treatment; thus patients remain infectious for a longer time, increasing
the risk of spreading resistant microorganisms to others. For example,
the emergence of Plasmodium falciparum multidrug resistance,
including resistance to ACTs in the Greater Mekong subregion is an
urgent public health concern that is threatening global efforts to
reduce the burden of malaria.




Although MDR-TB is a growing concern, it is still largely under-reported, compromising control efforts.