Document Detail

The role of the natural environment in the emergence of antibiotic resistance in gram-negative bacteria.
MedLine Citation:
PMID:  23347633     Owner:  NLM     Status:  MEDLINE    
During the past 10 years, multidrug-resistant Gram-negative Enterobacteriaceae have become a substantial challenge to infection control. It has been suggested by clinicians that the effectiveness of antibiotics is in such rapid decline that, depending on the pathogen concerned, their future utility can be measured in decades or even years. Unless the rise in antibiotic resistance can be reversed, we can expect to see a substantial rise in incurable infection and fatality in both developed and developing regions. Antibiotic resistance develops through complex interactions, with resistance arising by de-novo mutation under clinical antibiotic selection or frequently by acquisition of mobile genes that have evolved over time in bacteria in the environment. The reservoir of resistance genes in the environment is due to a mix of naturally occurring resistance and those present in animal and human waste and the selective effects of pollutants, which can co-select for mobile genetic elements carrying multiple resistant genes. Less attention has been given to how anthropogenic activity might be causing evolution of antibiotic resistance in the environment. Although the economics of the pharmaceutical industry continue to restrict investment in novel biomedical responses, action must be taken to avoid the conjunction of factors that promote evolution and spread of antibiotic resistance.
Elizabeth M H Wellington; Alistair B Boxall; Paul Cross; Edward J Feil; William H Gaze; Peter M Hawkey; Ashley S Johnson-Rollings; Davey L Jones; Nicholas M Lee; Wilfred Otten; Christopher M Thomas; A Prysor Williams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Lancet. Infectious diseases     Volume:  13     ISSN:  1474-4457     ISO Abbreviation:  Lancet Infect Dis     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-25     Completed Date:  2013-04-02     Revised Date:  2014-08-15    
Medline Journal Info:
Nlm Unique ID:  101130150     Medline TA:  Lancet Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-65     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Drug Resistance, Bacterial / genetics*
Gene-Environment Interaction*
Genome, Bacterial*
Gram-Negative Bacteria / genetics*
Gram-Negative Bacterial Infections / drug therapy
Manure / microbiology
Models, Biological
R Factors
Sewage / chemistry,  microbiology
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Manure; 0/Sewage

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