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Resistance sans frontières: containing antimicrobial resistance nationally and globally

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Coordinated action on several fronts is required

Antimicrobial resistance is everywhere, and everywhere invisible. Bacteria, which comprise the bulk of microscopic life, have lived on planet Earth for 3.4 billion years, giving them a huge amount of time to diversify, to establish themselves in almost all terrestrial and aquatic niches, and to develop advanced survival skills. Antimicrobial resistance is one of these skills. The agility with which bacteria acquire resistance to antimicrobial drugs is a perfect demonstration of those skills and of Darwin’s “survival of the fittest”.

Antimicrobials developed for therapeutic use are a very recent addition to the range of toxins in the bacterial environment. The introduction of sulfonamides in the 1930s was followed in the early 1940s by the development of penicillin, the first “miracle drug”, capable of killing bacteria causing infection in host tissues while causing no harm to the host.1 Resistance to both drug types emerged quite rapidly after their introduction into medical practice.2 Resistance has since developed, sooner or later, to all other classes of antimicrobials that have made their way into human and veterinary medicine, and into other fields of human activity.

Wherever antimicrobials are used, bacteria will be exposed and ultimately acquire resistance, by…