‘The Maternal Sepsis Intervention has had a profound impact on maternal mortality and antibiotic use whilst also reducing hospital costs. The Ministry of Health is keen to explore opportunities to extending the lessons learnt and integrate them in national policy-making.' -Dr. Richard Mugahi, Ministry of Health, Uganda. This open access book provides an accessible introduction to the mechanics of international development and global health text for policy-makers and students across a wide range of disciplines. Antimicrobial resistance is a major threat to the well-being of patients and health systems the world over. In fragile health systems so challenged, on a day-today basis, by the overwhelming burden of both infectious and non-communicable disease, it is easy to overlook the impacts of AMR. The Maternal Sepsis Intervention, focusing on a primary cause of maternal death in Uganda, demonstrates the systemic nature of AMR and the gains that can be made through improved Infection Prevention Control and direct engagement of laboratory testing in antibiotic prescribing.

Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.

Antimicrobial resistance is a major global public health problem. This book focuses on the clinical implications of multi-drug resistant pathogens; tracking AMR and its evolutionary significance; antifungal resistance; and current and alternative treatment strategies for AMR, including antivirulent, antibiofilm and antimicrobial resistance breakers, repurposing of drugs, and probiotic therapy. Advances in antimicrobial stewardship, antibiotic policies from a global perspective and their impacts are also discussed. The book also explores the use of omics approaches to gain insights into antibacterial resistance, and includes chapters on the potential benefits of a ‘One Health approach’ describing the environmental and zoonotic sources of resistant genes and their effects on the global resistance pool.

Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens-compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry-both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities. The IOM's Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation's food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation's food supply through the use of a "One Health" approach to food safety. Improving Food Safety Through a One Health Approach: Workshop Summary covers the events of the workshop and explains the recommendations for future related workshops.

Antibiotics are powerful drugs that can prevent and treat infections, but they are becoming less effective as a result of drug resistance. Resistance develops because the bacteria that antibiotics target can evolve ways to defend themselves against these drugs. When antibiotics fail, there is very little else to prevent an infection from spreading. Unnecessary use of antibiotics in both humans and animals accelerates the evolution of drug-resistant bacteria, with potentially catastrophic personal and global consequences. Our best defenses against infectious disease could cease to work, surgical procedures would become deadly, and we might return to a world where even small cuts are life-threatening. The problem of drug resistance already kills over one million people across the world every year and has huge economic costs. Without action, this problem will become significantly worse. Following from their work on the Review on Antimicrobial Resistance, William Hall, Anthony McDonnell, and Jim O’Neill outline the major systematic failures that have led to this growing crisis. They also provide a set of solutions to tackle these global issues that governments, industry, and public health specialists can adopt. In addition to personal behavioral modifications, such as better handwashing regimens, Superbugs argues for mounting an offense against this threat through agricultural policy changes, an industrial research stimulus, and other broad-scale economic and social incentives.

Antimicrobial resistance is one of our most serious health threats. Infections from resistant bacteria are now too common, and some pathogens have even become resistant to multiple types or classes of antibiotics. The loss of effective antibiotics will undermine our ability to fight infectious diseases and manage the infectious complications common in vulnerable patients undergoing chemotherapy for cancer, dialysis for renal failure, and surgery, especially organ transplantation, for which the ability to treat secondary infections is crucial. This report discusses the complex problem of antibiotic resistance today and the potentially catastrophic consequences of inaction. Its purpose is to increase awareness of the threat that antibiotic resistance poses and to encourage immediate action to address the threat. This document can serve as a reference for anyone looking for information about antibiotic resistance. For more technical information, references and links are provided. Figures. This is a print on demand report.