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Stuart Levy, M.D., Professor of Molecular Biology & Microbiology, Center for Adaptation Genetics & Drug Resistance, Tufts University
Bacterial resistance to multiple antibiotics is the mark of the 1990s and represents a legacy from misuse and overuse of antibiotics over the past several decades. While global in appearance, antibiotic resistance is a local phenomenon reflecting the consequences of inappropriate antibiotic use in people, animals and agriculture.
While hospitals and communities throughout the world confront antibiotic resistance, the organisms and resistance patterns may vary from one place to another. Some organisms, such as multidrug resistant S. aureus, vancomycin resistant enterococci, the multiresistant pneumococcus, gonococcus, and Mycobacterium tuberculosis, are worldwide problems. Other organisms are clearly more local and reflect local patterns of antibiotic use and infectious disease control.
Antibiotic resistance can be viewed as the interaction of two essential components in a "drug resistance equation"; the antibiotic and the resistance trait. Both are required to produce the clinical resistance problem, which is affected by the magnitude of the two factors. Reversal of the problem can be simply envisioned by diminishing one or both components. A more general theme should involve the protection and resuscitation of the susceptible microbial flora which have been decimated in the wake of antibiotic overuse. If given a chance, the susceptible bacteria which are still present in our environment can return to outcompete and replace resistant bacteria, thus restoring the microbial balance disturbed by antibiotics. |