Bacterial Antibiotic Resistance: on the Cusp of a Post-antibiotic World

Abstract

The specific aim of this article is to provide evidence that antibiotic resistance (AR) has become a human disease unto itself and to describe the current means of preventing, treating, and reversing AR in individuals and in affected populations. An ever-increasing number of infections are being classified as multidrug resistant (MDR). Low and middle-income countries are most likely to increase the spread of AR due to limited healthcare infrastructure coupled with policies that promote unregulated access to antibiotics. The genetic basis for AR has become more thoroughly understood as efforts move toward a global big data approach to surveille and implement effective public health measures. Antibiotic Stewardship (AS) programs are critical to prevent the spread of AR. As resistant pathogens reside in patients for many years after they are initially integrated into the microbiome, the potential for future infection increases substantially. This property contributes to the conclusion that AR is in and of itself a human disease that must be treated appropriately. While all bacteria are at risk to become AR, Staphylococcus, Klebsiella, Mycobacterium, Acinetobacter, and Pseudomonas represent the greatest challenges in infectious disease treatment as rapid AR acquisition leads to MDR infections.