More than a century of research, sparked by the germ theory of disease and rooted in historic notions of contagion that long precede Pasteur and Koch's 19th-century research and intellectual synthesis, underlies current knowledge of microbe-host interactions. This pathogen-centered understanding attributed disease entirely to the actions of "invading" microorganisms, thereby drawing the lines of battle between "them" and "us," the injured hosts. The considerable impact of this approach, further enabled by improvements in sanitation, diet, and living conditions in the industrialized world, served to cement the belief that humanity was engaged in a war against pathogenic microbes, and that we were winning.
Today, mechanisms of resistance have been reported for all known antimicrobial drugs that are currently available for clinical use in human and veterinary medicine. In some cases, strains have been isolated that are resistant to multiple antibacterial agents. Community-acquired infections are also frequently resistant to multiple antimicrobial drugs. Examples include community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), common respiratory pathogens such as Streptococcus pneumoniae, and gram-negative bacilli, which can infect humans through contaminated food. Preserving the effectiveness of current antimicrobials and encouraging the continued development of new ones are vital to protecting human and animal health.
The Institute of Medicine’s Forum on Microbial Threats will hold a public workshop on April 6th and 7th 2010 to explore the scientific and policy dimensions of the global spread of antimicrobial resistance. Through invited presentations and discussions, this workshop will address the evolutionary, genetic, and ecological origins of antimicrobial resistance and its increasing impact on human and animal health. Participants will explore the existing knowledge and unanswered questions indicated by (but not limited to) the following:
- case examples of the identification and spread of antimicrobial resistance in gram-negative and gram-positive bacteria;
- viruses; and parasites;
- host and environmental factors associated with disease susceptibility, resistance, and immunity, and the global spread of antimicrobial resistance;
- strategies for extending the useful life of antimicrobials;
- alternative approaches to treating infections, such as phage therapy; incentives and disincentives for the proper use of antimicrobials; and,
- incentives and disincentives for new antibiotic and antiviral drug development.
The workshop is free and open to the public, but registration is required.