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The presence of antibiotics, antibiotic resistance genes, and
antibiotic resistant bacteria in the environment (i.e., outside of
clinical settings, such as antibiotic-treated patients or
antibiotic-impregnated locations, such as hospitals) is a cause of
growing worldwide concern, as it reveals the extensive impact of
antibiotic abuse and other human-related pressures upon microbes.
Also, the potential clinical and environmental impact of the
presence of antibiotic resistance outside the obvious clinical
settings is mostly unknown, but could be unexpectedly large, as
resistance in clinical conditions can be seen as a very small "tip
of the iceberg". The field of detecting and measuring resistance in
the environment has rapidly evolved from mostly anecdotal reports
at the end of the 1990s, to a systematic search of organisms and
genes in a wide variety of settings, from ancient permafrost to
migratory birds. This book will review the available evidence and
hypotheses on where this resistance is coming from and for how long
it has been there; what are the selective and maintenance pressures
involved, and how is resistance spreading; what are the known and
possible traits that are being selected and spread along with
antibiotic resistance ones; what are the laboratory and in-silico
strategies to look into this issue, and their advantages and
disadvantages.
The presence of antibiotics, antibiotic resistance genes, and
antibiotic resistant bacteria in the environment (i.e., outside of
clinical settings, such as antibiotic-treated patients or
antibiotic-impregnated locations, such as hospitals) is a cause of
growing worldwide concern, as it reveals the extensive impact of
antibiotic abuse and other human-related pressures upon microbes.
Also, the potential clinical and environmental impact of the
presence of antibiotic resistance outside the obvious clinical
settings is mostly unknown, but could be unexpectedly large, as
resistance in clinical conditions can be seen as a very small "tip
of the iceberg". The field of detecting and measuring resistance in
the environment has rapidly evolved from mostly anecdotal reports
at the end of the 1990s, to a systematic search of organisms and
genes in a wide variety of settings, from ancient permafrost to
migratory birds. This book will review the available evidence and
hypotheses on where this resistance is coming from and for how long
it has been there; what are the selective and maintenance pressures
involved, and how is resistance spreading; what are the known and
possible traits that are being selected and spread along with
antibiotic resistance ones; what are the laboratory and in-silico
strategies to look into this issue, and their advantages and
disadvantages.
Avoiding infection has always been expensive. Some human
populations escaped tropical infections by migrating into cold
climates but then had to procure fuel, warm clothing, durable
housing, and crops from a short growing season. Waterborne
infections were averted by owning your own well or supporting a
community reservoir. Everyone got vaccines in rich countries, while
people in others got them later if at all. Antimicrobial agents
seemed at first to be an exception. They did not need to be
delivered through a cold chain and to everyone, as vaccines did.
They had to be given only to infected patients and often then as
relatively cheap injectables or pills off a shelf for only a few
days to get astonishing cures. Antimicrobials not only were better
than most other innovations but also reached more of the world's
people sooner. The problem appeared later. After each new
antimicrobial became widely used, genes expressing resistance to it
began to emerge and spread through bacterial populations. Patients
infected with bacteria expressing such resistance genes then failed
treatment and remained infected or died. Growing resistance to
antimicrobial agents began to take away more and more of the cures
that the agents had brought.
Avoiding infection has always been expensive. Some human
populations escaped tropical infections by migrating into cold
climates but then had to procure fuel, warm clothing, durable
housing, and crops from a short growing season. Waterborne
infections were averted by owning your own well or supporting a
community reservoir. Everyone got vaccines in rich countries, while
people in others got them later if at all. Antimicrobial agents
seemed at first to be an exception. They did not need to be
delivered through a cold chain and to everyone, as vaccines did.
They had to be given only to infected patients and often then as
relatively cheap injectables or pills off a shelf for only a few
days to get astonishing cures. Antimicrobials not only were better
than most other innovations but also reached more of the world's
people sooner. The problem appeared later. After each new
antimicrobial became widely used, genes expressing resistance to it
began to emerge and spread through bacterial populations. Patients
infected with bacteria expressing such resistance genes then failed
treatment and remained infected or died. Growing resistance to
antimicrobial agents began to take away more and more of the cures
that the agents had brought.
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