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Antimicrobial resistance (AMR) is when microbes are less treatable with one or more antimicrobial medications used to treat or prevent infection. There are three main ways by which resistance can occur: by natural resistance in certain types of bacteria, by genetic mutation, or by one species acquiring resistance from another. Resistance can happen spontaneously owing to random mutations, to a build up of resistance over time, or to misuse of antibiotics or antimicrobials, although the latter two pathways are the most important. Resistant microbes become increasingly difficult to treat, requiring alternative medications or higher doses, both of which may be more costly or more toxic. Microbes which are resistant to multiple antimicrobials are called multidrug resistant (MDR); in the press, these organisms are often referred to as superbugs. Antimicrobial resistance is an increasingly problematic issue that leads to millions of deaths every year. A few infections become completely untreatable due to resistance. All classes of microbes develop resistance (fungi, antifungal resistance; viruses, antiviral resistance; protozoa, antiprotozoal resistance; bacteria, antibiotic resistance). Of those categories, bacterial antibiotic resistance poses the largest threat to public health. Antibiotics should only be used when needed and only when prescribed by health professionals. When antibiotics are being prescribed, the prescriber should closely adhere to the five rights of drug administration: the right patient, the right drug, the right dose, the right route, and the right time. Narrow-spectrum antibiotics should be used rather than broad-spectrum antibiotics when possible to effectively and accurately target specific organisms. Cultures should be taken before treatment when indicated and treatment potentially changed based on the susceptibility report. For people who will be self-administering these medications in the home setting, emphasis must be placed on education about proper use of the drug. In practice, health care providers should try to minimize spread of resistant infections by using proper sanitations techniques including handwashing or disinfecting between each patient, and should encourage the same of the patient, visitors, and family members.〔 The rising trend in drug resistance can be attributed to three primary areas: use of antibiotics in the human population, use of antibiotics in the animal population, and the spread of resistant strains between human or non-human sources.〔 Any use of antibiotics can increase selective pressure in a population of bacteria, causing vulnerable bacteria to die thereby increasing the relative numbers of resistant bacteria and allowing for further growth. As resistance to antibiotics becomes more common there is greater need for alternative treatments. Call for new antibiotic therapies have been issued, but there is continuing decline in the number of approved drugs. The Centers for Disease Control and Prevention (CDC) has developed a monitoring program for the top 18 drug-resistant threats in the United States, categorized by level of concern; examples of common types of drug-resistant bacteria include: methicillin-resistant ''Staphylococcus aureus'' (MRSA), vancomycin-resistant ''S. aureus'' (VRSA), extended spectrum beta-lactamase (ESBL), vancomycin-resistant ''Enterococcus'' (VRE), multidrug-resistant ''A. baumannii'' (MRAB). A World Health Organization (WHO) report released April 2014 stated, "this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance—when bacteria change so antibiotics no longer work in people who need them to treat infections—is now a major threat to public health."〔("WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health" ) Retrieved 2014-05-02〕 There have been increasing public calls for global collective action to address the threat, including a proposal for an international treaty on antimicrobial resistance. Antibiotic resistance is not properly mapped across the world, but the countries that are affected the most are poorer countries with already weaker healthcare systems.〔 ==Definition== The WHO defines antimicrobial resistance as a microorganism's resistance to an antimicrobial drug that was once able to treat an infection by that microorganism.〔 A person cannot become resistant to antibiotics. Resistance is a property of the microbe, not a person or other organism infected by a microbe.〔(【引用サイトリンク】title=CDC: Get Smart: Know When Antibiotics Work )〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Antimicrobial resistance」の詳細全文を読む スポンサード リンク
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