Antimicrobial resistance in developing countries. Part I: recent trends and current status

The global problem of antimicrobial resistance is particularly pressing in developing countries, where the infectious disease burden is high and cost constraints prevent the widespread application of newer, more expensive agents. Gastrointestinal, respiratory, sexually transmitted, and nosocomial in...

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Bibliographic Details
Published in:The Lancet infectious diseases 2005-08, Vol.5 (8), p.481-493
Main Authors: Okeke, Iruka N, Laxminarayan, Ramanan, Bhutta, Zulfiqar A, Duse, Adriano G, Jenkins, Philip, O'Brien, Thomas F, Pablos-Mendez, Ariel, Klugman, Keith P
Format: Article
Language:English
Subjects:
Adult
Animal populations
Biological and medical sciences
Child, Preschool
Communicable Diseases - epidemiology
Communicable Diseases - mortality
Communicable Diseases - transmission
Cross Infection - epidemiology
Cross Infection - mortality
Developing Countries
Diarrhea - epidemiology
Diarrhea - microbiology
Diarrhea - mortality
Drug Resistance, Microbial
Epidemiology. Vaccinations
General aspects
Global Health
Human infectious diseases. Experimental studies and models
Humans
Infectious diseases
LDCs
Medical sciences
Nosocomial infection
Population Surveillance
Prevalence
Public health
Tuberculosis, Multidrug-Resistant - epidemiology
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Summary:The global problem of antimicrobial resistance is particularly pressing in developing countries, where the infectious disease burden is high and cost constraints prevent the widespread application of newer, more expensive agents. Gastrointestinal, respiratory, sexually transmitted, and nosocomial infections are leading causes of disease and death in the developing world, and management of all these conditions has been critically compromised by the appearance and rapid spread of resistance. In this first part of the review, we have summarised the present state of resistance in these infections from the available data. Even though surveillance of resistance in many developing countries is suboptimal, the general picture is one of accelerating rates of resistance spurred by antimicrobial misuse and shortfalls in infection control and public health. Reservoirs for resistance may be present in healthy human and animal populations. Considerable economic and health burdens emanate from bacterial resistance, and research is needed to accurately quantify the problem and propose and evaluate practicable solutions. In part II, to be published next month, we will review potential containment strategies that could address this burgeoning problem.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(05)70189-4