Resistance problems

What is driving resistance?

The number of bacteria that are resistant to antimicrobials is increasing worldwide. The more antimicrobials are used, the greater the chance that bacteria will develop resistance. Every time an antibiotic is used inappropriately, the development of antimicrobial resistance can accelerate. Furthermore, antimicrobial resistance knows no national borders, and affects all countries regardless of their economic status. In addition, the increased mobility of the global population means that resistance in one area of the world can be carried to another area with relative ease. Increasing antimicrobial resistance urges governments and the medical profession throughout the world to take active and concrete measures to address this threat.

First, to combat resistance, it is important to base the choice to prescribe antimicrobials on the individual patient and the infection concerned with the proper choice of medication, dose, frequency and duration. 

Second, it is important that it quickly becomes clear when resistant bacteria are involved and that proper tests are used to determine this. 

Third, it is important that healthcare providers carefully follow the antimicrobial guidelines and change medication when appropriate, i.e. when new diagnostic results indicates that change is required, or prolonged treatment is dangerous for the individual patient 

Fourth, it is important that healthcare providers carefully follow existing hygiene procedures, such as handwashing, in order to prevent resistant bacteria from spreading.

Resistance impact

 ESBL is an enzyme that allows bacteria to become resistant to a wide variety of penicillins and cephalosporins, including extended spectrum cephalosporins. The use of antibiotics in humans and animals promotes the spread of ESBL producing bacteria.

  • Methicillin-resistant Staphylococcus aureus (MRSA) bacteria are resistant to all beta-lactam antibiotics such as methicillin, penicillin, oxacillin, and amoxicillin. MRSA causes skin and wound infections, pneumonia, and bloodstream infections. 
  • Carbapenem-resistant Enterobacteriaceae (CRE) are nightmare bacteria that are resistant to nearly all antimicrobials and spread easily. Almost half of hospital patients in the US who get bloodstream infections from CRE bacteria die from the infection.
  • Clostridium difficile (C. difficile) causes diarrhea mostly in people who have recently had medical care and treated with high doses of antimicrobials for a prolonged time.  In some circumstances, C. difficile can be fatal.