Antimicrobial resistance: an overview.

Increased antimicrobial resistance in bacteria that are important pathogens of humans, and spread of resistance from the closed environment of hospitals into open communities are increasingly perceived as a threat to public health. Any antimicrobial use, whether in humans, animals, plants or food processing technology, could lead to bacterial resistance. Use of antimicrobials in livestock production is suspected to significantly contribute to this phenomenon in species of bacteria which are common to humans and animals. Further research is required into the specific use conditions that govern the selection and dissemination of resistant bacteria. International travel and trade in animals and food increase the risks of antimicrobial resistance world-wide. Countries are considering import restrictions for products deemed a risk to public health. The Office International des Epizooties, a World Trade Organization reference organisation for the Agreement on the Application of Sanitary and Phytosanitary Measures, develops international standards on antimicrobial resistance which, as is the case for national measures, must be based on risk analysis. The scientific background and problems of resistance in human medicine are reviewed. Current knowledge, missing information and actions to be taken are identified.