Ever since the dawn of the antibiotic age, bacteria have adapted by developing new resistance mechanisms to antimicrobial agents. Mast remains at the forefront of the fight against these threats to effective antimicrobial therapy.
The prevalence of antibiotic resistance increasingly threatens the delivery of crucial health services in hospitals and in the community, with escalating reports of enterobacterial isolates with reduced susceptibility to carbapenems and third-generation cephalosporins. Of particular concern is the limited availability of therapeutic options caused by the dwindling supply of new, effective antibiotics targeting emerging multidrug-resistant (MDR) bacteria.
In the 1980s, Gram-negative bacteria were almost universally susceptible to oxyimino-cephalosporins, carbapenems and fluoroquinolones, but are now fighting back, developing a multitude of resistance mechanisms that prevent antibiotics reaching their targets, or destroy drugs by AmpC enzymes, extended-spectrum beta-lactamases (ESBLs) and carbapenemases. With the accumulation of antibiotic resistance evolving faster than antibiotic development, there is an increased awareness of the impact of MDR bacteria in medical settings, with patients requiring longer, more toxic and expensive treatment in hospitals.
Accordingly, prompt detection is essential to help guide patient treatment and for infection prevention and control, as many genes responsible for such resistance are readily transferable on plasmids. Detection remains a challenge caused by the diversity of emerging resistance mechanisms, which are continually evolving with newer targets being increasingly identified.
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