**12. Antimicrobial resistance**

Resistance to antibiotics and other types of antimicrobial agents is growing and represents the single greatest challenge in the treatment of infectious diseases today. According to WHO, "AMR occurs when microorganisms change when they are exposed to antibiotic and antimicrobial drugs." Due to anti microbial resistance, antimicrobial agents turning ineffective and infections persist in the body, increasing the risk of spread to others. AMR affects the effective prevention, and treatment of infections caused by bacteria, parasites, viruses, and fungi. WHO says that AMR is a growing and alarming threat to global public health that requires lot of action from the government. Moreover, people should get a lot of awareness message regarding antimicrobial resistance. An antimicrobial resistance developing microorganisms are sometimes called as "superbugs" [38].

As per WHO cost analysis data, health care cost of resistant infections is higher than nonresistant infections because of


Global WHO statistics says that a total of 480,000 people develop multidrug resistant TB each year, and drug resistance is starting complication in treatment of HIV and malaria as well.

#### **12.1. Emergence of drug-resistant bacteria**

Emergence of penicillinase-producing *Staphylococcus aureus* and emergence and spread of multidrug-resistant *S. aureus* in the early 1960s, emergence of MRSA in 1961, emergence of PISP in 1967, emergence of penicillinase-producing *H. influenzae* in 1974, emergence of PRSP in 1977, emergence of BLNAR *H. influenzae* in 1980, emergence of ESBL-producing Gram-negative bacilli in 1983, emergence of VRE in 1986, increased infections with MRSA, PRSP, BLNAR, etc. and increase of resistant *gonococci* in 1990s, increase of MDRP, and increase of quinolone-resistant *E. coli* in 2000s are the emergence of drug resistance bacteria.

Major reasons for increasing antimicrobial resistance:


**12. Antimicrobial resistance**

Penicillins, cephalosporins, carbapenems, polypeptide

**Table 3.** Different antimicrobial agents and its mechanism of action.

Lincosamides, aminoglycosides, macrolides,

tetracyclines, chloramphenicol

antibiotics

called as "superbugs" [38].

sistant infections because of

• Longer duration of illness

• Use of more expensive drugs

**12.1. Emergence of drug-resistant bacteria**

• Additional tests

Resistance to antibiotics and other types of antimicrobial agents is growing and represents the single greatest challenge in the treatment of infectious diseases today. According to WHO, "AMR occurs when microorganisms change when they are exposed to antibiotic and antimicrobial drugs." Due to anti microbial resistance, antimicrobial agents turning ineffective and infections persist in the body, increasing the risk of spread to others. AMR affects the effective prevention, and treatment of infections caused by bacteria, parasites, viruses, and fungi. WHO says that AMR is a growing and alarming threat to global public health that requires lot of action from the government. Moreover, people should get a lot of awareness message regarding antimicrobial resistance. An antimicrobial resistance developing microorganisms are sometimes

Bactericidal Inhibition of cell wall synthesis

Bacteriostatic Inhibition of protein synthesis

**Antimicrobial agents Effect on bacteria Mechanism**

56 Microbiology of Urinary Tract Infections - Microbial Agents and Predisposing Factors

Quinolones, metronidazole Bactericidal Inhibits DNA synthesis

Sulfonamides Bacteriostatic Competitive inhibition

Rifamycins Bactericidal Inhibitions of RNA transcription

As per WHO cost analysis data, health care cost of resistant infections is higher than nonre-

Global WHO statistics says that a total of 480,000 people develop multidrug resistant TB each year, and drug resistance is starting complication in treatment of HIV and malaria as well.

Emergence of penicillinase-producing *Staphylococcus aureus* and emergence and spread of multidrug-resistant *S. aureus* in the early 1960s, emergence of MRSA in 1961, emergence of PISP in 1967, emergence of penicillinase-producing *H. influenzae* in 1974, emergence of PRSP in 1977, emergence of BLNAR *H. influenzae* in 1980, emergence of ESBL-producing


Major mechanisms for acquired antimicrobial resistance:

