title: Antimicrobial resistance in healthcare, agriculture and the environment: the biochemistry behind the headlines.
abstract: The crisis of antimicrobial resistance (AMR) is one of the most serious issues facing us today. The scale of the problem is illustrated by the recent commitment of Heads of State at the UN to coordinate efforts to curb the spread of AMR infections. In this review, we explore the biochemistry behind the headlines of a few stories that were recently published in the public media. We focus on examples from three different issues related to AMR: (i) hospital-acquired infections, (ii) the spread of resistance through animals and/or the environment and (iii) the role of antimicrobial soaps and other products containing disinfectants in the dissemination of AMR. Although these stories stem from three very different settings, the underlying message in all of them is the same: there is a direct relationship between the use of antimicrobials and the development of resistance. In addition, one type of antimicrobial could select for cross-resistance to another type and/or for multidrug resistance. Therefore, we argue the case for increased stewardship to not only cover clinical use of antibiotics, but also the use of antimicrobials in agriculture and stewardship of our crucially important biocides such as chlorhexidine.
authors.affiliation: School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia rietie.venter@unisa.edu.au.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Venter
authors.affiliation: School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Henningsen
authors.affiliation: School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Begg
mesh_terms: D000383:Agriculture; D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology*; D001671:Biochemistry; D003695:Delivery of Health Care; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004777:Environment; D006801:Humans; D012915:Soaps / Q000494:pharmacology
chemical_list: D000890:Anti-Infective Agents; D012915:Soaps
keywords: antimicrobial resistance; antiseptic; cross-resistance; hospital acquired infections; last resort antibiotic; spread of resistance