Resistance mechanisms: A problem and an approach to the solution

Abstract

Bacterial resistance is a growing problem worldwide. Treatment of bacterial infections is more difficult every day, not only in hospitals but also in the community. If it was possible to cure infections with penicillin 60 years ago, now we require the use of three or four antibiotics in order to treat an infection caused by microorganisms resistant to several antimicrobial families (multidrug-resistance), and cases of infections due to bacteria resistant to all available antibiotics have already been described. Among the reasons that can explain the sustained increase in resistance are the indiscriminate use of antibiotics for viral infections (where they are not necessary), the use of antibiotics of very wide spectrum for infections that do not require them (e.g., carbapenems in respiratory tract infections in the community), inadequate dosage or very prolonged treatments, and, lastly, the use of antibiotics in animals that end up transmitting resistance genes in human beings during their consumption (Paulson and Zaoutis, Pediatrics 136(6):e1670-7, 2015). It is a priority to take measures to contain resistance, on the one hand, through the strategy of antibiotic management, strict adherence to the multimodal WHO multimodal hand hygiene strategy, compliance with contact isolation precautions, active surveillance of colonized patients, and cohortization of patients with infections by multidrug-resistant microorganisms.