The importance of infection control in tackling the antimicrobial resistance crisis

The current global crisis caused by antimicrobial-resistant organisms is the natural culmination of the battle between evolution and humanity's ability to develop new antimicrobial agents, a battle that it would appear the microorganisms are winning. Without effective antimicrobial treatments many healthcare interventions that are currently regarded as routine, such as chemotherapy, organ transplantation and elective surgical procedures, may no longer be possible due to the associated risks of infection.

Antimicrobial resistance (AMR) occurs naturally by genetic mutation and natural selection. When exposed to antimicrobial agents, sensitive strains are killed, leaving the resistant strains to survive and multiply. Ever since Sir Alexander Fleming discovered penicillin in 1928 microorganisms have inevitably been evolving and developing resistance to antimicrobial agents.

Meticillin-resistant Staphylococcus aureus (MRSA) emerged within 2 years of the drug meticillin being introduced in 1960. More recently, the world has seen the emergence and rapid global dissemination of some strains of bacteria, such as carbapenemase-producing enterobacteriaceae (CPE), which are resistant to virtually all available antibiotics.