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Microb Drug Resist. 2013 Apr;19(2):73-87. doi: 10.1089/mdr.2012.0115. Epub 2012 Oct 9.

Antibiotic resistance: from Darwin to Lederberg to Keynes.

Author information

1
Fundación Lusara, Mexico City, Mexico. carlos.amabile@lusara.org

Abstract

The emergence and spread of antibiotic-resistant bacteria reflects both, a gradual, completely Darwinian evolution, which mostly yields slight decreases in antibiotic susceptibility, along with phenotypes that are not precisely characterized as "resistance"; and sudden changes, from full susceptibility to full resistance, which are driven by a vast array of horizontal gene transfer mechanisms. Antibiotics select for more than just antibiotic resistance (i.e., increased virulence and enhanced gene exchange abilities); and many non-antibiotic agents or conditions select for or maintain antibiotic resistance traits as a result of a complex network of underlying and often overlapping mechanisms. Thus, the development of new antibiotics and thoughtful, integrated anti-infective strategies is needed to address the immediate and long-term threat of antibiotic resistance. Since the biology of resistance is complex, these new drugs and strategies will not come from free-market forces, or from "incentives" for pharmaceutical companies.

PMID:
23046150
DOI:
10.1089/mdr.2012.0115
[Indexed for MEDLINE]

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