Public Health Importance of Antimicrobial Resistance

Infectious diseases were the primary cause of mortality in mankind prior to the discovery and use of antimicrobials. In much of the developing world, infectious diseases continue be major killers because of the lack of effective, good quality antimicrobials, and in all countries healthcare-associated infectious with resistance microorganisms are a major cause of death.

Antimicrobial resistance is an unusual public health threat

• Antimicrobial resistance is not a "disease". Typically, there is no difference in the severity of disease caused by susceptible strains and resistant ones. Resistance is generally not a problem of disease pathology but one of limited therapy options.
• The core issue is our dependence on antimicrobials for treating infections. If there were alternate methods of treating infections, antimicrobial resistance would persist in the world but would no longer be relevant as a public health concern.
• Antimicrobial resistance is a public health threat driven by healthcare practices, most notably the overuse of antimicrobials in conditions for which they provide no benefit.
• Resistance is a characteristic of many pathogens causing different diseases. Containment strategies thus must be adapted to the needs of specific disease control and treatment programs.

Some Leading Resistant Pathogens

Bacteria - Community

• Escherichica coli
• Mybocaterium tuberculosis (cause of tuberculosis)
• Neisseria gonorrhoeae (cause of gonorrhoea)
• Salmonella Typhi
• Staphylococcus aureus
• Streptococcus pneumoniae

Bacteria - Hospitals

• Acinetobacter baumanni
• Enterococcus faecium and Enterococcus faecalis
• Escherichia coli
• Klebsiella pneumoniae
• Pseudomonas aeruginosa
• Staphylococcus aureus

Bacteria - Zoonotic disease

• Campylobacter species
• Salmonella species

Fungi

• Candida albicans

Parasites

• Leishmania species
• Plasmodium species (cause of malaria)
• Trypanosoma species

Viruses

• Cytomyegalovirus
• Herpes simplex
• HIV

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