Antibiotic resistance and antibiotic alternatives: looking towards the future.

Abstract

The international interdisciplinary conference on Resistance and Antibiotic Alternatives: Looking towards the Future was held in London in November 2015. The issue of antibiotic resistance of microorganisms is among the most pertinent themes and major worldwide concerns for medical, veterinary and social communities. This is why the conference attracted the attention of researches from all over the world. During the three days of intensive work, scientists and physicians from Europe, North and South America, Asia, Africa and Australia gave more than 20 lectures and exhibited about 60 poster presentations in three sessions: Antimicrobial Resistance (Chair: Dr Stephen Mortlock), Replacing Antibiotics (Chair: Dr Konstantinos Beis) and Infection Control and Industrial Applications (Chair: Dr Sanjib Bhakta). Each session was followed by free discussions, during which the participants exchanged ideas and suggested interesting approaches to solving the problem. Most of the lectures and posters discussed the reasons and sources of antibiotic resistance, including excessive use and misuse of antibiotics as well as incomplete treatment for bacterial infections in humans and in veterinary medicine. Antibiotic circulation in the soil-water-humans-animals-fish chain plays an important role in the development of antibiotic resistance. Antibiotic-resistant species are found within the community as well as in hospital pathogens, and their ever increasing number leads to inefficient clinical treatment, prolonged hospitalisation and rising patient mortality. Antibiotic resistance poses a serious threat to mankind, is causing a worldwide increase in the number of patients infected by drug-resistant bacteria, difficulties in treatment of common infections and tens of thousands of deaths annually. The appearance of multidrug-resistant bacterial strains has seriously exacerbated the situation. The problem demands immediate globally coordinated solutions. Otherwise, mankind may enter a post-antibiotic era when people could die from the most common infections, as occurred in the pre-antibiotic era. This issue was discussed by Dr Prakash U. Tahiliani from the Prime Ever Ayurvedic Research Laboratories (Navsari, Gujarat, India), who spoke about this danger for mankind and stressed the need to take urgent steps to cope with the problem of natural and acquired antibiotic resistance. Dr Stephen Mortlock from the University of Surrey (Guildford, UK) raised the issue of the prevalence of infections in the community which are caused by one of the major hospital-acquired pathogens, S. aureus, especially MRSA strains. This phenomenon is attributed to misuse of antibiotics in prior antimicrobial therapy or previous hospitalisation of patients, particularly in less developed countries. Fifteen years of surveillance in Ecuador revealed a significant diversity in antibiotic resistance rates between one specific hospital and the nationwide hospital net, as reported by Dr Jeannete Zurita (The Biomedical Research Unit, Zurita & Zurita Laboratorios, Quito, Ecuador). It was assumed that specific conditions, including the employment of highly qualified staff, adherence to hygiene protocols and control over antibiotic consumption, can lead to lower resistance rates. Special attention was paid by lecturers to mechanisms of bacterial resistance to antibiotics, which include the action of drug efflux pumps in case of intrinsic as well as acquired resistance and proteolytic degradation of antibiotics. The latter can be carried out, for instance, by [beta]-lactamases, New Delhi metallo-[beta]-lactamase 1, carbapenemases or membrane-associated resistance proteins, when the genes coding for these enzymes are located in multidrug-resistance plasmids or in chromosomes. The increased resistance of microorganisms in biofilms compared to planktonic cells is related to poor penetration of antibiotics into a biofilm matrix, to the specific microenvironment in biofilms and to launching of adaptive mechanisms by microorganisms. …