The 2008 Garrod Lecture: Antimicrobial resistance--animals and the environment

The evolution of resistance to microbes is one of the most significant problems in modern medicine, posing serious threats to human and animal health. The early work on the use of antibiotics to bacterial infections gave much hope that infectious diseases were no longer a problem, especially in the human field. However, as their use, indeed over-use, progressed, resistance (both monoresistance and multiresistance), which was often transferable between different strains and species of bacteria, emerged. In addition, the situation is increasingly complex, as various mechanisms of resistance, including a wide range of beta-lactamases, are now complicating the issue. The use of antibiotics in animals, especially those used for growth promotion, has come in for serious criticism, especially those where their use should be reserved for difficult human infections. To lend control, certain antibiotic growth promoters have been banned from use in the EU and the UK. Antimicrobial resistance is not confined to bacteria but occurs in viruses, protozoa and helminths. In many of these, the mechanism of resistance is unknown, and hence their control is still in question. It is likely, however, that the mechanisms are no less complicated than those pertaining to bacteria.