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Antibiotics represent one of the most successful forms of therapy in medicine. But the efficiency of antibiotics is compromised by the growing number of antibiotic-resistant pathogens. Antibiotic resistance, which is implicated in elevated morbidity and mortality rates as well as in the increased treatment costs, is considered to be one of the major global public health threats (www.who.int/drugresistance/en/) and the magnitude of the problem recently prompted a number of international and national bodies to take actions to protect the public (http://ec.europa.eu/dgs/health_consumer/docs/road-map-amr_en.pdf: http://www.who.int/drugresistance/amr_global_action_plan/en/; http://www.whitehouse.gov/sites/default/files/docs/carb_national_strategy.pdf). Understanding the mechanisms by which bacteria successfully defend themselves against the antibiotic assault represent the main theme of this eBook published as a Research Topic in Frontiers in Microbiology, section of Antimicrobials, Resistance, and Chemotherapy. The articles in the eBook update the reader on various aspects and mechanisms of antibiotic resistance. A better understanding of these mechanisms should facilitate the development of means to potentiate the efficacy and increase the lifespan of antibiotics while minimizing the emergence of antibiotic resistance among pathogens.
On December 4â€"5, 2019, the National Academies of Sciences, Engineering, and Medicine held a 1.5-day public workshop titled Exploring the Frontiers of Innovation to Tackle Microbial Threats. The workshop participants examined major advances in scientific, technological, and social innovations against microbial threats. Such innovations include diagnostics, vaccines (both development and production), and antimicrobials, as well as nonpharmaceutical interventions and changes in surveillance. This publication summarizes the presentations and discussions from the workshop.
Summary report published as technical document with reference number: WHO/HSE/PED/AIP/2014.2.
With the expansion of the breeding production scale and the development of the food industry, the prevalence of foodborne pathogens and subsequent problems including food poisoning and antimicrobial resistance (AMR), contribute much to the global disease burden, leading to the serious health hazard and major economic losses around the world, and foodborne disease has become one of the most challenging issues to public health. The most common pathogens spreading foodborne diseases in humans include but are not limited to Salmonella, Campylobacter, Clostridium, Cronobacter, pathogenic Escherichia coli, Listeria monocytogenes, Staphylococcus aureus, Vibrio parahaemolyticus, Bacillus cereus, Yersinia enterocolitica, etc. These pathogens contaminate various types of foods throughout the food chain including cereal, vegetable, fruit, meat, dairy, and aquatic products in entire proceedings from farmland to fork and disseminate AMR and virulence. In this process, some clinically important antimicrobial-resistant pathogens, such as carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), colistin-resistant or tigecycline-resistant bacteria have spread so quickly that they could be found emerging in clinical hospitals, agricultural farmlands, foods, food animals, environments and also humans/animals guts, in the meantime, super-bug foodborne pathogens with high-level AMR or hypervirulence has been disclosed emerging or re-emerging in more and more publications. Omics techniques including genomics, proteomics, transcriptomics, and metabonomics have greatly improved our understanding of the mechanisms of foodborne pathogens in terms of their AMR and pathogenesis. Simultaneously, an integrated multi-disciplinary “One Health” approach has been used for widespread and sustained surveillance of foodborne pathogens, based on a multi-sectoral collaboration framework, to mitigate and prevent the threats of pathogens of animal-, human-, environment- and food- origins. Though a large number of foodborne pathogen isolates were collected with unfolded phenotypic characteristics as the phase goals for surveillance work, it is still far from clearly exploring how many super-bugs there were, why they were so resistant or hypervirulent, where they came from, how they disseminated, how the mechanisms transmitted and evolved, and what the potential hazards were, etc. We need more intensive and compelling evidence, explanation, and interpretation. This Research Topic aims to provide a platform for recent discoveries and the latest progress in detection, mechanism, and dissemination from Omics insights with regards to the emerging or re-emerging foodborne pathogens with high-level AMR (Multi-drug resistant/Extensively-drug resistant/Pan-drug resistant, MDR/XDR/PDR) or hypervirulence, to increase the understanding of these superbugs, to track their sources, to discover the mechanisms that make them super, and to uncover the dissemination along the animal-food-human chain based on big data, and to assess the human health risks by uptaking them. Emergence, mechanism, and dissemination of them via the food chain by using the application of Omics-based technologies would be of particular interest for this topic. This Research Topic welcomes authors worldwide to contribute any article types like Original Research, Review & Mini-Review, Methods, Hypothesis and Theory, and Perspectives related to this topic, especially for some rare or unusual isolates with extreme importance and significance. Themes in the Research Topic include but are not limited to the sub-topics we suggested below: 1. Detection, prevalence, phenotypic characterizations, risk assessment, and regional or long-term surveillance of the “super-bug” foodborne pathogens; 2. Mechanisms (especially novel mechanisms) explanation/exploration or drug target development using Omics-based technologies and bioinformatics analysis; 3. Regionally or global dissemination of “super-bug” foodborne pathogen clones or relevant determinants especially mobile genetic elements (MGEs); 4. Current advances in the novel and instant detection method/models or method comparison report for the pathogenicity phenotype of the foodborne pathogens; 5. Any pathogen/disease prevention control and clinical treatment management developed to oppose the “super-bug” foodborne pathogen, like the gut microbiota approach, etc. Please note that Frontiers in Microbiology does not accept Case Reports, Clinical Trials, and Systematic Reviews, hence Frontiers in Public Health is a better option. Conflict of Interest: Dr. Scott Van Nguyen works for ATCC. All other topic editors declare no conflict of interest.
Infectious diseases are a global hazard that puts every nation and every person at risk. The recent SARS outbreak is a prime example. Knowing neither geographic nor political borders, often arriving silently and lethally, microbial pathogens constitute a grave threat to the health of humans. Indeed, a majority of countries recently identified the spread of infectious disease as the greatest global problem they confront. Throughout history, humans have struggled to control both the causes and consequences of infectious diseases and we will continue to do so into the foreseeable future. Following up on a high-profile 1992 report from the Institute of Medicine, Microbial Threats to Health examines the current state of knowledge and policy pertaining to emerging and re-emerging infectious diseases from around the globe. It examines the spectrum of microbial threats, factors in disease emergence, and the ultimate capacity of the United States to meet the challenges posed by microbial threats to human health. From the impact of war or technology on disease emergence to the development of enhanced disease surveillance and vaccine strategies, Microbial Threats to Health contains valuable information for researchers, students, health care providers, policymakers, public health officials. and the interested public.
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.
Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens-compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry-both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities. The IOM's Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation's food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation's food supply through the use of a "One Health" approach to food safety. Improving Food Safety Through a One Health Approach: Workshop Summary covers the events of the workshop and explains the recommendations for future related workshops.
The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.
"In May 2015, the Sixty-eighth World Health Assembly adopted the Global action plan on antimicrobial resistance, which reflects the global consensus that AMR poses a profound threat to human health. One of the five strategic objectives of the Global action plan is to strengthen the evidence base through enhanced global surveillance and research. The Global Antimicrobial Resistance Surveillance System (GLASS) has been developed to facilitate and encourage a standardized approach to AMR surveillance globally and in turn support the implementation of the Global action plan on antimicrobial resistance. This manual addresses the early phase of implementation of GLASS, focussing on surveillance of resistance in common human bacterial pathogens. The intended readership of this publication is public health professionals and health authorities responsible for national AMR surveillance. It outlines the GLASS standards and describes the road map for implementation of the system between 2015 and 2019. Further development of GLASS will be based on the lessons learnt during this period"--Publisher's description.