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Microbiology Australia Microbiology Australia
Issue 2

Antimicrobial Resistance

Vertical Transmission

We are now one-third of the way through 2019 and it is striking to me how prominent microbiology has been in our mainstream media this year. In particular, in human health we have seen the emergence of new and deadly microbes such as Candida auris, a multi-resistant fungal pathogen first described in 2009 in Japan. Within a decade C. auris has spread worldwide, causing infections or facility outbreaks in over a dozen countries, and it was identified in an Australian patient in 2018. The ease with which C. auris is transmitt...

Antimicrobial resistance

In this issue, we present a series of short overviews on important topics with a common theme. In their paper, Djordjevic and Morgan point out the impact of antimicrobial resistance on food security and remind us of the importance of understanding the relationships between animals (including humans) and the environment when considering antibiotic resistance, particularly those elements of it that are part of normal genomic plasticity and readily transferable. This sentiment is echoed in a sobering description of the classic post-antibiotic oppo...

Gonococcal antimicrobial resistance: 80 years in the making

Antimicrobial resistance has been a problem for the treatment of gonorrhoea since the introduction of sulfa drugs in the 1930s. The gonococcus has a remarkable ability to obtain the genetic elements required to develop resistance and for these resistant strains to then widely disseminate. Many decades of antibiotic monotherapy have seen the introduction of a number of antibiotic classes herald a promising new era of treatment only to subsequently fail due to resistance development. The world is now faced with the prospect of extensively resista...

The rise and rise of antimicrobial resistance in Gram-negative bacteria

Antimicrobial resistance is a major threat to the delivery of effective care and already causes 700000 excess deaths per year worldwide. International consensus on action to combat antimicrobial resistance was reached in 2015. Australia is implementing a national strategy. The clinical consequences of antimicrobial resistance are seen most acutely in multi-drug resistant Gram-negative bacterial infections, where they cause increased mortality and morbidity and threaten the delivery of once routine medical care. The solution to antimicrobial res...

Laboratory automation impact on antimicrobial resistance

Antibiotic resistance in common bacterial pathogens, such as Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae, has significantly limited the therapeutic options available for management of infectious diseases. While the indiscriminant use of broad spectrum antibiotics is a significant contributing factor, a more fundamental problem exists. Diagnostic microbiology test results have historically been available too late to be useful. This is, in part, due to the nature of the test methods and in part due to w...

The Australian Group on Antimicrobial Resistance (AGAR)

The Australian Group on Antimicrobial Resistance (AGAR) is a collaboration of clinicians and scientists working in diagnostic medical microbiology laboratories located across Australia. The group gathers information on the level of antimicrobial resistance (AMR) in bacteria causing important and life threatening infections and is a key component of Australia's response to the problem of increasing AMR. It defines where Australia stands with regard to antimicrobial resistance in human health.

A One Health genomic approach to antimicrobial resistance is essential for generating relevant data for a holistic assessment of the biggest threat to public health

Antimicrobial resistance (AMR) threatens modern medicine as we know it. AMR infections may ultimately be untreatable and routine surgeries will become inherently risky1. By 2050 more people may die of drug-resistant infections (DRIs) every year than of cancer, which equates to more than 10 million annual deaths globally2 and the World Bank has estimated that AMR could cost the global economy $1 trillion every year after 2030. DRIs also lead to an increase in the length of hospital stays,...

The impact of antimicrobial resistance on induction, transmission and treatment of Clostridium difficile infection

Clostridium difficile infection (CDI) of the gastrointestinal (GI) tract is a potentially life-threatening disease that has surpassed multi-drug-resistant Staphylococcus aureus as the commonest antimicrobial-resistant organism associated with healthcare1. This obligate anaerobic spore-forming Gram-positive bacillus colonises the GI tract and its numbers increase after disruption of the commensal GI microbiota often induced by exposure to antimicrobial agents2. Paradoxically...

Recent developments in the diagnosis of drug-resistant tuberculosis

Urgent steps are required to control the drug-resistant tuberculosis (TB) epidemic worldwide. Individualised treatment, using detailed drug-susceptibility test results to guide choice of antibiotics, improves patient outcomes and minimises adverse effects. Recent years have seen substantial advances in our ability to provide rapid, detailed drug-resistance profiles using genotypic methods for detection of mutations conferring drug-resistance. Rapid testing using real-time PCR to target the most important drug-resistance mutations allows the dia...

Insights into the global emergence of antifungal drug resistance

The global prevalence of fungal diseases has escalated in the last several decades. Currently, it is estimated that fungi infect 1.7 billion people annually and result in 1.5 million deaths every year1. Deaths due to fungal infections are increasing, with mortality often exceeding 50%, further increasing to 100% if treatment is delayed1. Despite these staggering figures, the contribution of fungal infections to the global burden of disease remains under-recognised. In Australia, over a 5...

The diminished antimicrobial pipeline

Australians love antibiotics, with one of the highest rates of human antibiotic usage in the world. Unfortunately, they are being loved to death, as high rates of inappropriate use, both here and around the globe, are contributing to the rise of drug-resistant bacteria against which our current arsenal of antibiotics is becoming increasingly ineffective. In the past, advancements in developing new antibiotics kept pace with developing resistance, but we are now facing a deadly reality where the pipeline of ‘new and improved' antibiotics ...

Volume 40 Number 2

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