The antimicrobial resistance crisis: management through gene monitoring

Antimicrobial resistance (AMR) is an acknowledged crisis for humanity. Its genetic origins and dire potential outcomes are increasingly well understood. However, diagnostic techniques for monitoring the crisis are currently largely limited to enumerating the increasing incidence of resistant pathoge...

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Bibliographic Details
Published in:Open biology 2016-11, Vol.6 (11), p.160236
Main Authors: Michael, Carolyn A., Franks, Ashley E., Labbate, Maurizio
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents
Antimicrobial Resistance
Bacteria - genetics
Bacterial Proteins - genetics
Crisis Management
Drug Resistance, Bacterial
Evolution
Evolution, Molecular
Gene Frequency
Genome, Bacterial
Horizontal Gene Transfer
Humans
Perspective
Prospective Studies
Selection, Genetic
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Summary:Antimicrobial resistance (AMR) is an acknowledged crisis for humanity. Its genetic origins and dire potential outcomes are increasingly well understood. However, diagnostic techniques for monitoring the crisis are currently largely limited to enumerating the increasing incidence of resistant pathogens. Being the end-stage of the evolutionary process that produces antimicrobial resistant pathogens, these measurements, while diagnostic, are not prognostic, and so are not optimal in managing this crisis. A better test is required. Here, using insights from an understanding of evolutionary processes ruling the changing abundance of genes under selective pressure, we suggest a predictive framework for the AMR crisis. We then discuss the likely progression of resistance for both existing and prospective antimicrobial therapies. Finally, we suggest that by the environmental monitoring of resistance gene frequency, resistance may be detected and tracked presumptively, and how this tool may be used to guide decision-making in the local and global use of antimicrobials.
ISSN:2046-2441
2046-2441
DOI:10.1098/rsob.160236