34
2.1 Introduction
Antimicrobial resistance is the acquired ability of a microbe to resist the effects of
antimicrobials that once could successfully treat the microbe (Ferri et al. 2017).
Resistance is acquired horizontally by one of the following mechanisms: (i) drug
efflux pumps, (ii) enzymatic modification of binding site, (iii) modification or inactivation of enzymatic drug, acquisition of a novel drug resistant target, (v) target
protection by drug displacement (Barlam et al. 2016). Once the microbe becomes
resistant, more difficult is to treat the infection caused by it. Microbes resistant to
more than one class of antimicrobials are called multidrug resistant (Arzanlou et al.
2017). Extensively drug resistant are those which are resistant to more than two
classes of antimicrobials. Healthcare associated infections and antimicrobial resistance are mounting menaces to public health and the global health care systems
(MacVane 2017). Antimicrobial resistance in humans is well connected with antimicrobial resistance in other populations, particularly farm animals, and in the large
environment (Arzanlou et al. 2017). Antimicrobial resistance is caused by overuse
of antibiotics, which was predicted by Alexander Fleming; who said ‘The time may
come when penicillin can be bought by anyone in the shops’. The lack of information substantially prohibits the coordination of approaches and evaluation of the
effectiveness of interventions. The persistent tide of threats shown by healthcare
associated infections and antimicrobial resistance cannot be curbed without
enhancement of global surveillance systems. Specific programs should be initiated
and supported financially in every region on the basis of existing network structures.
A robust monitoring and evaluation platform now contributes to evidence based
interventions (Tacconelli et al. 2018). An incorporated system for the surveillance
of antimicrobial resistance still needs to be established. This chapter focuses on
global surveillance systems to define the status, recent advancements, main limitations, and unmet needs of improved antimicrobial resistance surveillance programs
worldwide (Simjee et al. 2018).
2.2 Resistance Surveillance History
Around 5 decades ago, infections in the calves were reported in United Kingdom
due to multidrug resistance Salmonella enterica serovar Typhimurium (Akkina
et al. 1999; Threlfall et al. 1994). Such infections became prominent due to adoption
of intensive farming practices such as rampant use of antimicrobial in the feed without prescriptions, which further resulted in transmission of infections to humans.
This epidemic could be avoided not by use of massive antibiotics but by improvement of animal husbandry conditions and by decreasing the initiation and spread of
diseases through monitoring (Braden 2006).
In 1970, a monitoring program for Salmonella antimicrobial resistance surveillance in animals initiated in the United Kingdom, and surveys were conducted in
S. Kumar et al.
2.1 Introduction
Antimicrobial resistance is the acquired ability of a microbe to resist the effects of
antimicrobials that once could successfully treat the microbe (Ferri et al. 2017).
Resistance is acquired horizontally by one of the following mechanisms: (i) drug
efflux pumps, (ii) enzymatic modification of binding site, (iii) modification or inactivation of enzymatic drug, acquisition of a novel drug resistant target, (v) target
protection by drug displacement (Barlam et al. 2016). Once the microbe becomes
resistant, more difficult is to treat the infection caused by it. Microbes resistant to
more than one class of antimicrobials are called multidrug resistant (Arzanlou et al.
2017). Extensively drug resistant are those which are resistant to more than two
classes of antimicrobials. Healthcare associated infections and antimicrobial resistance are mounting menaces to public health and the global health care systems
(MacVane 2017). Antimicrobial resistance in humans is well connected with antimicrobial resistance in other populations, particularly farm animals, and in the large
environment (Arzanlou et al. 2017). Antimicrobial resistance is caused by overuse
of antibiotics, which was predicted by Alexander Fleming; who said ‘The time may
come when penicillin can be bought by anyone in the shops’. The lack of information substantially prohibits the coordination of approaches and evaluation of the
effectiveness of interventions. The persistent tide of threats shown by healthcare
associated infections and antimicrobial resistance cannot be curbed without
enhancement of global surveillance systems. Specific programs should be initiated
and supported financially in every region on the basis of existing network structures.
A robust monitoring and evaluation platform now contributes to evidence based
interventions (Tacconelli et al. 2018). An incorporated system for the surveillance
of antimicrobial resistance still needs to be established. This chapter focuses on
global surveillance systems to define the status, recent advancements, main limitations, and unmet needs of improved antimicrobial resistance surveillance programs
worldwide (Simjee et al. 2018).
2.2 Resistance Surveillance History
Around 5 decades ago, infections in the calves were reported in United Kingdom
due to multidrug resistance Salmonella enterica serovar Typhimurium (Akkina
et al. 1999; Threlfall et al. 1994). Such infections became prominent due to adoption
of intensive farming practices such as rampant use of antimicrobial in the feed without prescriptions, which further resulted in transmission of infections to humans.
This epidemic could be avoided not by use of massive antibiotics but by improvement of animal husbandry conditions and by decreasing the initiation and spread of
diseases through monitoring (Braden 2006).
In 1970, a monitoring program for Salmonella antimicrobial resistance surveillance in animals initiated in the United Kingdom, and surveys were conducted in
S. Kumar et al.