MECHANISMS AND IMPLICATIONS OF ANTIBIOTIC RESISTANCE: A GLOBAL PUBLIC HEALTH CHALLENGE
Main Article Content
Keywords
Antibiotic Resistance, Alternative therapies, Bacteria, Antimicrobial, Horizontal gene transferTop of Form
Abstract
Antibiotic resistance is a global public health crisis that threatens the effectiveness of treatments for bacterial infections. The rapid rise of multidrug-resistant organisms (MDROs), driven by the overuse and misuse of antibiotics in healthcare, agriculture, and environmental settings, has rendered many infections difficult to treat. This review explores the mechanisms of antibiotic resistance, such as horizontal gene transfer and spontaneous mutations, and examines the role of factors like overprescription, misuse, and environmental contamination in accelerating the spread of resistance. The implications for public health are severe, leading to increased morbidity, mortality, and healthcare costs. Furthermore, antibiotic resistance undermines modern medical procedures, such as surgeries and cancer treatments, which depend on effective antibiotics. Global strategies to combat antibiotic resistance include promoting antibiotic stewardship, improving infection control, and encouraging responsible antibiotic use in agriculture. Alongside policy initiatives, scientific innovation is crucial, with new antibiotics and alternative therapies—such as antimicrobial peptides, bacteriophage therapy, and CRISPR-based interventions—offering potential solutions. Coordinated international efforts and continued investment in research are essential to mitigate the impact of antibiotic resistance and protect global health.
References
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35. Poole, K. (2007). Efflux pumps as antimicrobial resistance mechanisms. Annals of Medicine, 39(3), 162-176.
36. Pouwels, K. B., Dolk, F. C. K., Smith, D. R. M., Robotham, J. V., & Smieszek, T. (2019). Actual versus ‘ideal’antibiotic prescribing for common conditions in English primary care. Journal of Antimicrobial Chemotherapy, 74(10), 3070-3074.
37. Pursey, E., Sünderhauf, D., Gaze, W. H., Westra, E. R., & van Houte, S. (2018). CRISPR-Cas antimicrobials: challenges and future prospects. PLOS Pathogens, 14(6), e1006990.
38. Sirota, M., Round, T., Samaranayaka, S., & Kostopoulou, O. (2017). Expectations for antibiotics increase their prescribing: Causal evidence about localized impact. Health Psychology, 36(4), 402-409.
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2. Berglund, B. (2015). Environmental dissemination of antibiotic resistance genes and correlation to anthropogenic contamination with antibiotics. Infection Ecology & Epidemiology, 5(1), 28564.
3. Boehm, A. B., Sassoubre, L. M., Oshima, K. H., & Salveson, A. (2014). Enteric pathogen load in coastal water and sediment: A quantitative microbial risk assessment of exposure to surfers. Environmental Science & Technology, 48(15), 8843-8852.
4. Brown, E. D. (2015). Antibiotic adjuvants: creating new opportunities for novel therapeutics. PLOS Pathogens, 11(4), e1004866.
5. Brown, E. D., & Wright, G. D. (2016). Antibacterial drug discovery in the resistance era. Nature, 529(7586), 336-343.
6. Bush, K., & Bradford, P. A. (2016). β-Lactams and β-lactamase inhibitors: an overview. Cold Spring Harbor Perspectives in Medicine, 6(8), a025247.
7. Cassini, A., Högberg, L. D., Plachouras, D., Quattrocchi, A., Hoxha, A., Simonsen, G. S., ... & Kretzschmar, M. E. (2019). Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. The Lancet Infectious Diseases, 19(1), 56-66.
8. Centers for Disease Control and Prevention (CDC). (2019). Antibiotic resistance threats in the United States. U.S. Department of Health and Human Services. Available at:
9. Costerton, J. W., Stewart, P. S., & Greenberg, E. P. (1999). Bacterial biofilms: a common cause of persistent infections. Science, 284(5418), 1318-1322.
10. Czaplewski, L., Bax, R., Clokie, M., Dawson, M., Fairhead, H., Fischetti, V. A., ... & Mullany, P. (2016). Alternatives to antibiotics–a pipeline portfolio review. The Lancet Infectious Diseases, 16(2), 239-251.
11. Davies, J., & Davies, D. (2010). Origins and evolution of antibiotic resistance. Microbiology and Molecular Biology Reviews, 74(3), 417-433.
12. Du, D., Wang, Z., James, N. R., Voss, J. E., Klimont, E., Ohene-Agyei, T., ... & Luisi, B. F. (2018). Structure of the AcrAB-TolC multidrug efflux pump. Nature, 509(7501), 512-515.
13. Dyar, O. J., Huttner, B., Schouten, J., & Pulcini, C. (2017). What is antimicrobial stewardship? Clinical Microbiology and Infection, 23(11), 793-798.
14. Fleming-Dutra, K. E., Hersh, A. L., Shapiro, D. J., Bartoces, M., Enns, E. A., File, T. M., ... & Hicks, L. A. (2016). Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA, 315(17), 1864-1873.
15. Hall, C. W., & Mah, T. F. (2017). Molecular mechanisms of biofilm-based antibiotic resistance and tolerance in pathogenic bacteria. FEMS Microbiology Reviews, 41(3), 276-301.
16. Hernando-Amado, S., Coque, T. M., Baquero, F., & Martínez, J. L. (2019). Defining and combating antibiotic resistance from One Health and Global Health perspectives. Nature Microbiology, 4(9), 1432-1442.
17. Hill, C., Guarner, F., Reid, G., Gibson, G. R., Merenstein, D. J., Pot, B., ... & Salminen, S. (2014). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology & Hepatology, 11(8), 506-514.
18. Holloway, K. A., & Van Dijk, L. (2011). The World Medicines Situation 2011: Rational Use of Medicines. World Health Organization.
19. Johnston, C., Martin, B., Fichant, G., Polard, P., & Claverys, J. P. (2014). Bacterial transformation: distribution, shared mechanisms and divergent control. Nature Reviews Microbiology, 12(3), 181-196.
20. Kalia, V. C., Patel, S. K. S., & Shanmugam, R. (2016). Quorum sensing inhibitors: an overview. Biotechnology Advances, 34(7), 1234-1247.
21. Kaye, K. S., Pogue, J. M., Infections, A. I., & Control. (2010). Infections caused by resistant gram-negative bacteria: epidemiology and management. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 30(11), 1135-1148.
22. Klein, E. Y., Van Boeckel, T. P., & Martinez, E. M. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proceedings of the National Academy of Sciences, 115(15), E3463-E3470.
23. Kortright, K. E., Chan, B. K., Koff, J. L., & Turner, P. E. (2019). Phage therapy: a renewed approach to combat antibiotic-resistant bacteria. Cell Host & Microbe, 25(2), 219-232.
24. Kümmerer, K. (2009). Antibiotics in the aquatic environment–a review–part I. Chemosphere, 75(4), 417-434.
25. Larsson, D. G. J., de Pedro, C., & Paxeus, N. (2007). Effluent from drug manufacturers contains extremely high levels of pharmaceuticals. Journal of Hazardous Materials, 148(3), 751-755.
26. Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A. K., Wertheim, H. F., Sumpradit, N., ... & Cars, O. (2013). Antibiotic resistance—the need for global solutions. The Lancet Infectious Diseases, 13(12), 1057-1098.
27. Llor, C., & Bjerrum, L. (2014). Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic Advances in Drug Safety, 5(6), 229-241.
28. Mahlapuu, M., Håkansson, J., Ringstad, L., & Björn, C. (2016). Antimicrobial peptides: an emerging category of therapeutic agents. Frontiers in Cellular and Infection Microbiology, 6, 194.
29. Manyi-Loh, C., Mamphweli, S., Meyer, E., & Okoh, A. (2018). Antibiotic use in agriculture and its consequential resistance in environmental sources: potential public health implications. Molecules, 23(4), 795.
30. Marshall, B. M., & Levy, S. B. (2011). Food animals and antimicrobials: impacts on human health. Clinical Microbiology Reviews, 24(4), 718-733.
31. Munita, J. M., & Arias, C. A. (2016). Mechanisms of antibiotic resistance. Microbiology Spectrum, 4(2), 10.1128/microbiolspec.VMBF-0016-2015.
32. National Institute of Allergy and Infectious Diseases. (n.d.). Antimicrobial resistance: Causes. National Institutes of Health. Retrieved October 29, 2024
33. O'Neill, J. (2016). Tackling drug-resistant infections globally: final report and recommendations. Review on Antimicrobial Resistance.
34. Partridge, S. R., Kwong, S. M., Firth, N., & Jensen, S. O. (2018). Mobile genetic elements associated with antimicrobial resistance. Clinical Microbiology Reviews, 31(4), e00088-17.
35. Poole, K. (2007). Efflux pumps as antimicrobial resistance mechanisms. Annals of Medicine, 39(3), 162-176.
36. Pouwels, K. B., Dolk, F. C. K., Smith, D. R. M., Robotham, J. V., & Smieszek, T. (2019). Actual versus ‘ideal’antibiotic prescribing for common conditions in English primary care. Journal of Antimicrobial Chemotherapy, 74(10), 3070-3074.
37. Pursey, E., Sünderhauf, D., Gaze, W. H., Westra, E. R., & van Houte, S. (2018). CRISPR-Cas antimicrobials: challenges and future prospects. PLOS Pathogens, 14(6), e1006990.
38. Sirota, M., Round, T., Samaranayaka, S., & Kostopoulou, O. (2017). Expectations for antibiotics increase their prescribing: Causal evidence about localized impact. Health Psychology, 36(4), 402-409.
39. Smith, R., Coast, J., & Antimicrobial resistance: the true cost. (2013). The economic and health costs of antibiotic resistance. BMJ, 346, f1493.
40. Soucy, S. M., Huang, J., & Gogarten, J. P. (2015). Horizontal gene transfer: building the web of life. Nature Reviews Genetics, 16(8), 472-482.
41. Tang, Q., Fu, Y., Zhang, Z., & Li, X. (2019). Advances in nanotechnology-based functional coatings for combating bacterial infections. Nanomaterials, 9(1), 7.
42. Teillant, A., Gandra, S., Barter, D., Morgan, D. J., & Laxminarayan, R. (2015). Potential burden of antibiotic resistance on surgery and cancer chemotherapy antibiotic prophylaxis in the USA: a literature review and modelling study. The Lancet Infectious Diseases, 15(12), 1429-1437.
43. Ventola, C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and Therapeutics, 40(4), 277-283.
44. von Wintersdorff, C. J., Penders, J., van Niekerk, J. M., Mills, N. D., Majumder, S., van Alphen, L. B., ... & Savelkoul, P. H. (2016). Dissemination of antimicrobial resistance in microbial ecosystems through horizontal gene transfer. Frontiers in Microbiology, 7, 173.
45. Weiner, L. M., Webb, A. K., Limbago, B., Dudeck, M. A., Patel, J., Kallen, A. J., ... & Edwards, J. R. (2016). Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. Infection Control & Hospital Epidemiology, 37(11), 1288-1301.
46. Weiner-Lastinger, L. M., Abner, S., Benin, A. L., Edwards, J. R., Kallen, A. J., Karlsson, M., ... & Dudeck, M. A. (2020). The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network. Infection Control & Hospital Epidemiology, 43(1), 12-25.
47. World Health Organization (WHO). (2015). Global action plan on antimicrobial resistance. World Health Organization.
48. World Health Organization (WHO). (2020). Antibiotic resistance: Key facts.
49. Zurawski, D. V., & McLendon, M. K. (2016). Monoclonal antibodies as an antibacterial approach against bacterial pathogens. Antibiotics, 5(3), 19.
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Nov 6, 2024
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MECHANISMS AND IMPLICATIONS OF ANTIBIOTIC RESISTANCE: A GLOBAL PUBLIC HEALTH CHALLENGE. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 45-59. https://doi.org/10.53555/ztnsyy41
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Author Biographies
Mamta Rani
Assistant Professor, Department of Pharmacology, MAMC, Agroha
Kuldeep Saharawat
DM Gastroenterology, Consultant, Sukhda Multi-Specialty Hospital, Hisar
How to Cite
MECHANISMS AND IMPLICATIONS OF ANTIBIOTIC RESISTANCE: A GLOBAL PUBLIC HEALTH CHALLENGE. (2024). Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 45-59. https://doi.org/10.53555/ztnsyy41