Antibiotic ResistanceFrom genes to global prevalence

Launched December 2009 Updated December 2016 25 lectures
Prof. Stephen Gillespie
University of St. Andrews, UK
Summary

Antibiotics have proved to be one of the most significant medical advances. Not long after the introduction of the first agents the problem of resistance emerged. In the early years of the antibiotic age, drug discovery progressed rapidly and new drugs solving old problems obscured the resistance threat. In recent... read moreyears the stream of new agents has dried to a trickle and now we are increasingly aware that options for antibiotic treatment are narrowing year on year. This problem is exacerbated by widespread use of antibiotics in human medicine and animal health. Medicine too has changed and more patients are living with immunodeficiency where they are at risk of organisms resistant to a wide range of therapeutics. Moreover, hospital practice has seen the rise of multiple drug resistant nosocomial pathogens such as MRSA and Glycopeptide resistant enterococci. In primary community pathogens too we have seen an inexorable upward trend in resistance. Old assumptions that resistant organisms were naturally less fit have been disproved by the upward trends in resistance and experimental evidence has helped us understand the evolutionary science behind this fact.

The purpose of this series of lectures is to provide a comprehensive overview of the major topics related to antibiotic resistance. This will be achieved by addressing the basic science of the evolution of resistance followed by examples of the epidemiology and clinical impact of the resistant pathogens that represent important clinical problems or illustrate key issues related to pathogen groups. This will be complemented by description of the methods to make a diagnosis of resistance and to perform effective surveillance in the hospital, local community or at a national level. The series is concluded by lectures that explore mechanisms of controlling resistance and that describe methods to overcome resistance.