Antimicrobial Use and Antimicrobial Resistance: A Population Perspective

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Lipsitch, Marc ; Samore, Matthew H.
• Description:
  The need to stem the growing problem of antimicrobial resistance has prompted multiple, sometimes conflicting, calls for changes in the use of antimicrobial agents. One source of disagreement concerns the major mechanisms by which antibiotics select resistant strains. For infections like tuberculosis, in which resistance can emerge in treated hosts through mutation, prevention of antimicrobial resistance in individual hosts is a primary method of preventing the spread of resistant organisms in the community. By contrast, for many other important resistant pathogens, such as penicillin-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus faecium resistance is mediated by the acquisition of genes or gene fragments by horizontal transfer; resistance in the treated host is a relatively rare event. For these organisms, indirect, population-level mechanisms of selection account for the increase in the prevalence of resistance. These mechanisms can operate even when treatment has a modest, or even negative, effect on an individual host's colonization with resistant organisms.
• Subjects:
  Anti-Bacterial Agents Antimicrobial Resistance Bacteria Disease Transmission, Infectious Drug Resistance, Bacterial Drug Utilization Ecological Study Epidemiologic Methods Evolution, Molecular Gene Transfer, Horizontal Humans Infectious Disease Transmission Mathematical Model Models, Biological Perspective Population Dynamics Prevalence Selection, Genetic

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• Source:
  Emerg Infect Dis. 8(4):347-354.
• Document Type:
  Journal Article
• Volume:
  8
• Issue:
  4
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:a8d9e7db43e1cd609cd1e8c4dd97fa2934f839c8a1546cbf31b60cd4e34022d8
• Download URL:
  https://stacks.cdc.gov/view/cdc/13827/cdc_13827_DS1.pdf
• File Type:
  [PDF - 1.06 MB ]