Surveying Antimicrobial Resistance The New Complexity Of The Problem

In January of 2015, under the 1st International Caparica Conference in Antibiotic Resistance, a Research Topic entitled: “Surveying Antimicrobial Resistance: Approaches, Issues, and Challenges to overcome”, was published (http://journal.frontiersin.org/researchtopic/3763/surveying-antimicrobial-resistanceapproaches- issues-and-challenges-to-overcome). The problem of antimicrobial resistance (AMR), caused by excessive and inappropriate use of antibiotics, is a public health issue that concerns us all. The introduction of penicillin in the 1940s, the start of the antibiotics era, has been recognized as one of the greatest advances in therapeutic medicine. However, according to the World Health Organization (WHO), AMR infections are now an increasing worldwide public health threat and a post-antibiotic era is imminent, where common infections and minor injuries could be fatal. AMR is a typical ‘One Health’ problem, in which livestock animals and the environment constitute AMR reservoirs and transmission routes to and from the human population. Without effective antimicrobials to counter and prevent infections, other major achievements in modern medicine, such as organ transplantation, cancer chemotherapy and major surgery, risk being compromised. AMR infections in animals have negative outcomes on animal health, welfare, biosecurity and production. In 2006, the ban of growth promoting antibiotics highlighted antibiotic use in animal production as a risk factor in the development of antibiotic resistant bacteria. Bacteria can be transferred to humans via several routes; consumption of animal products, exposure through contact with animals, and the contamination of ground and surface waters by animal waste products. Therefore, it is of utmost importance that antimicrobial use in animals is reduced to a minimum, without compromising animal health and welfare. Mechanisms of bacterial antibiotic resistance are classified according to the types of antibiotic molecules or their targets in the cell. Environmental antibiotic-resistance genes are spread then acquired by clinically relevant microorganisms. Many resistance genes are conveyed into pathogen genomes via mobile genetic elements such as plasmids, transposons or integrons, increasing the propagation of potential resistant pathogens. Substantial progress has already been made in elucidating the basic regulatory networks that endow bacteria with their extraordinary capacity to adapt to a diversity of lifestyles and external stress factors. So how will we face bacteria in the future?