Antibiotic resistance in the environment, with particular reference to MRSA

Gaze, William, O'Neill, Colette, Wellington, Elizabeth and Hawkey, Peter (2008) Antibiotic resistance in the environment, with particular reference to MRSA. Advances in applied microbiology, 63, 249-280. (doi:10.1016/S0065-2164(07)00007-X).

Abstract

The evolution of antibiotic resistant bacteria is one of the most significant problems in modern medicine and poses a serious threat to human health. Increasingly the huge diversity of resistance genes that already exist in the environment is beginning to be appreciated. Understanding the selective pressures and mechanisms of gene transfer that drive dissemination of resistance genes not only in the clinic, but also in the wider environment is crucial for long-term strategies in the treatment of microbial disease. Modern farming practice is attempting to reduce dependency on antibiotics but this in itself may not reduce particular mechanisms of resistance such as genes carried on class 1 integrons, which is highlighted can be selected for by biocides in the environment. Understanding the ecology of resistance genes is extremely difficult as genes may be carried by unculturable bacteria (99.0–99.9% of bacteria). Movement of genes between environmental bacteria and the clinic has therefore been difficult to investigate in the past. However, modern molecular approaches such as epidemiological studies of key resistance determinants in total community DNA using quantitative real-time PCR allows detailed analyses and comparison of gene prevalence in the environment and human gut.

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