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Chapter 1. Introduction to the Resistanc... > Antibiotic Resistance Is Widespread

Antibiotic Resistance Is Widespread

The seriousness of antibiotic resistance depends on perspective. For most diseases, we still have at least one effective drug. If we instantly stopped all resistance from increasing, our healthcare system could continue to perform well. But clinical scientists see resistance increasing and call the situation “dire.”13 For some pathogens, such as MRSA and Acinetobacter, physicians are forced to turn to antibiotics abandoned decades ago due to their toxic side effects. Our collective task is to develop attitudes and policies that enable all of us to use antibiotics without causing resistance to increase.

We estimate the extent of the resistance problem by surveillance studies. As pointed out, physicians collect microbial samples from patients and send the samples to clinical laboratories for testing (more than 2 billion per year in the United States14). Pathogens are cultured, and their susceptibility to specific antibiotics is determined (described in Chapter 2, “Working with Pathogens”). Surveillance workers then collect the data and calculate the percentage of the cultures that are resistant. (MIC breakpoints are used as the criterion for resistance.) This percentage, called the prevalence of resistance, indicates whether a particular antibiotic treatment is likely to fail due to pre-existing resistance. Surveillance also reveals trends when samples are obtained over several years from a similar patient population. Seeing the prevalence of resistance increase gives health planners advance warning that a change in treatment regimen is required.


  

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