Volume 3, Issue 3, December 2008
Professor, Department of Microbiology, The Chinese University of Hong Kong
Introduction - Global Concerns and Challenges
Throughout the world, healthcare professionals are concerned at the growing problem of antimicrobial resistance and the global emergence of multi-drug-resistant organisms (MDROs) in the health care setting and in the community. The use of penicillin in early 1940s on a wider scale, and the subsequent newly-introduced antimicrobials, was soon followed by the emergence of resistantmicrobes. Some of the seresistant organisms in relation to the introduction of antimicrobial agents are listed in Table 1. The prevalence of MDROs has increased dramatically worldwide during the last decades . Most alarmingly are in infections caused by MDROs whereby resistance has developed for virtually all currently available drugs and no effective therapies are available. This is compromised by the lack of new discovery of potent classes of antimicrobials in recent time, with shortfalls in funding for the development of new drugs which often relies on interests andsupport from pharmaceutical industries.
In a wider context, this threat to treatment and control of infectious diseases ranges beyond that of common bacterial pathogens. Drug resistance to infectious agents causing tuberculosis, malaria, pandemics of HIV, and in fluenza including H5N1, is also increasingly recognized, affecting treatment and hampering their containment. Antimicrobial resistance makes infections more difficult to treat; prolongs duration and increases severity of illness. This lengthens the period of infectivity, enhances spread and poses the added challenge to infection control. In effect, this translates to increases in direct and indirect health care costs and a higher morbidity and mortality.