A brief summary of the manuscript, Update on the Antibiotic Crisis by Rossolini et al. (2014)
Key Points:
- Developing new antibiotics is only a stop-gap solution to a growing antibiotic resistance crisis.
- Drugs able to treat the newest strains of resistant bacteria are still years away, while resistance continues to spread.
Summary
Antibiotics are one of the most important discoveries of modern medicine. It is estimated that over the past 70 years as many as 30% of all human lives have been saved from premature death due to the intervention of antibiotics (MMWR, 1999). However, antibiotics have been increasingly losing their potency, as more and more bacteria are able to resist their effects. Over the years, this has been counteracted by developing new types of antibiotics. However, bacterial adaption has begun to outpace our efforts in the development of new antibiotics. As a result, the antibiotic resistance crisis has been increasing significantly over the past decade (Fukunda and WHO, 2014). In 2014, several European scientists summarized the growing level of resistance among important bacterial species from a clinical perspective in an update on the antibiotic resistance crisis.
The authors highlight that although resistance in Gram-positive bacteria is a resistance problem that is widespread and well-known, with methicillin-resistant Staphylococcus aureus (MRSA) being one of the most significant examples, growing resistance among Gram-negative bacteria is alarming (Table 1). Gram-negative bacteria tend to be resistant to a larger variety of drugs and because of this are harder to destroy. One of the most concerning developments has been in Acinetobacter spp. These microorganisms have developed resistance to all available antibiotics except for polymyxins, though isolated cases of resistance have been reported to these final-defense drugs (Moskowitz et al., 2012). A result is an increasing number of resistant nosocomial infections (acquired in the hospital), especially resulting in pneumonia, due to A. baumannii.
Table 1. Bacterial species with known resistance to commonly available antibiotic treatments
| Bacterial Species or Family | Known to have mostly (MDR), extremely (XDR) or totally drug-resistant (TDR) strains | Available Antibiotic Treatment(s) |
|---|---|---|
| Gram Positive | ||
| Staphylococcus aureus | MDR | Glycopeptides, linezolid, tigecycline, daptomycin, new beta lactams |
| Enterococcus spp. | MDR | Linezolid, quinupristin |
| Gram Negative | ||
| Pseudamonas aeruginosa | MDR, XDR | Polymyxins |
| Acinetobacter spp. | XDR | Polymyxins |
| Enterobacteriaceae spp. (including Klebsiella pneumoniae & Escherichia coli) | XDR | Polymyxins, tigecycline, fosfomycin, gentamicin |
| Nesseria gonorrhoeae | XDR | Combination of ceftriazone, azythromycin |
Selected References
Fukunda, K., WHO. (2014). Antimicrobial Resistance: Global Report on Surveillance. Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/112642/9789241564748_eng.pdf
MMWR. (1999). Achievements in Public Health, 1900-1999: Control of Infectious Diseases. Atlanta, GA. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm
Moskowitz, S. M., Brannon, M. K., Dasgupta, N., Pier, M., Sgambati, N., Miller, A. K., … Høiby, N. (2012). PmrB mutations promote polymyxin resistance of Pseudomonas aeruginosa isolated from colistin-treated cystic fibrosis patients. Antimicrobial Agents and Chemotherapy, 56(2), 1019–30. https://doi.org/10.1128/AAC.05829-11
Authors
Written by Zach Trout while an Undergraduate Researcher in the Dept. of Biological Systems Engineering, University of Nebraska. Reviewed by Mara Zelt, University of Nebraska and Jovana Kovacevic, Oregon State University.
The scientific research summarized in this article was published as:
Rossolini, G. M., Arena, F., Pecile, P., Pollini, S. (2014). Update on the antibiotic resistance crisis. Curr Opin Pharmacol. 2014 Oct; 18: 56-60. https://doi.org/10.1016/j.coph.2014.09.006
This article presents the author’s interpretation of the published research for a general audience and should not be considered a reflection of the position or opinion of the researchers.