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Our poster discusses an overview of antibiotic resistance. It goes into detail about what it is, how it came to be, and what medical professionals can do in their attempt to prevent it, as well as the general public. It also discusses the impact the impact antibiotic resistance has had on pharmacy, as well as the science behind it. A few organizations working towards this problem, and who keep a close eye on this issue are mentioned as well. We also discuss the determinants of health, which is essentially what is being done about it politically, individually, and the health services provided. Our goal is to stress the importance of properly taking antibiotics, and the potential to prevent this problem from happening. We hope you take some insight behind this issue after reading, and sparks an interest in this topic. ; https://digitalcommons.cedarville.edu/public_health_posters/1020/thumbnail.jpg

INTRODUCTION: Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation. METHODS: PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used. RESULTS: In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research. CONCLUSION: Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally.

1. Definitions and basic concepts -- 2. Have antibiotics and antibiotic resistance genes always been out there? -- 3. Human-related release of antibiotics into the environment -- 4. Spread of resistant organisms from human settlements into the environment -- 5. Impact of antibiotics and resistance in non-clinical settings.

Policy-makers play a key role in tackling the emerging public health problem of antibiotic resistance. Antibiotic resistance is a result of the misuse, and especially the overuse, of antibiotics. Antibiotic resistance leads to excess morbidity and deaths. The problem is urgent. In the European Union more than 25 000 people die each year from common resistant bacterial infections. Owing to variable diagnostic capacity and a lack of data in countries, including Albania the number for the whole Region is not known. Antibiotic resistance increases health care costs. The estimated total cost to society of antibiotic resistance in the European Union alone is estimated to be € 1.5 billion resistant bacteria or genes that carry this information can spread easily. The use of antibiotics in animals sometimes outweighs their use in humans. Antibiotic resistance could take us back to the pre-antibiotic era. The complexity of the problem and the large number of sectors involved require strong national coordination, surveillance systems, national guidelines and sector-wide action plans. Based on good practices of national coordination of several European countries in many countries serve as reference in the conclusions to develop strategic action plan by the Albanian health institutions that aim to: I. Strengthen national multi sectorial coordination for the containment of antibiotic resistance II. Strengthen national surveillance of antibiotic resistance III. Promote national strategies for the rational use of antibiotics and strengthen national surveillance of antibiotic consumption IV. Strengthen infection control and surveillance of antibiotic resistance in health care settings V. Prevent and control the development and spread of antibiotic resistance in the food chain VII. Improve awareness, patient safety and partnership The complex nature of antibiotic resistance and the use of antibiotics requires the involvement of a wide array of actors:

The antibiotic resistance (antimicrobial resistance – AMR) and the particular emergence of multi-resistant bacterial strains, is a problem of clinical relevance involving serious threats to public health worldwide. From early this decade, a lot of studies have demonstrated a significant increase in the rates of antibiotic resistance by bacterial pathogens responsible for nosocomial and community infections all over the world. The AMR leads to a reduced drug efficacy in the treatment options available and therefore, to an increase in mortality rates. The original causes of the phenomenon are: environmental factors which favor a mutation of the genetic bacterial inheritance, thereby inhibiting the active ingredient of the antibiotics; unsuitable administering of antibiotics in veterinary, incorrect taking both in hospitals and at home and, lately, lack of investments in the development of new drugs. The alarming epidemiological data prompted the World Health Organization (WHO) in 2011 to coin the slogan "No action today, no cure tomorrow" in order to immediately implement a new strategy to improve the use of available drugs and to accelerate the introduction of new ones through a new phase of research involving private and public institutions. The European Union has stressed that the surveillance is considered an essential factor for an effective response to this problem but it has also highlighted that the results produced have been lower than expectations because of serious shortcomings such as lack of methodological standards, insufficient data sharing and no coordination among European countries. In Italy the situation is much more troubling; in fact, according to the Ministry of Health, 5000-7000 yearly deaths are deemed due to nosocomial infections, with an annual cost of more than 100 million €.These figures explain how the fight against infections is far from being won. The purpose of this review is to analyze the basic causes of the recurrence of the phenomenon, to explain the steps taken by the most important international organizations to face AMR and finally to suggest a possible way to search for new classes of antibiotics.

The antibiotic resistance (antimicrobial resistance – AMR) and the particular emergence of multi-resistant bacterial strains, is a problem of clinical relevance involving serious threats to public health worldwide. From early this decade, a lot of studies have demonstrated a significant increase in the rates of antibiotic resistance by bacterial pathogens responsible for nosocomial and community infections all over the world. The AMR leads to a reduced drug efficacy in the treatment options available and therefore, to an increase in mortality rates. The original causes of the phenomenon are: environmental factors which favor a mutation of the genetic bacterial inheritance, thereby inhibiting the active ingredient of the antibiotics; unsuitable administering of antibiotics in veterinary, incorrect taking both in hospitals and at home and, lately, lack of investments in the development of new drugs. The alarming epidemiological data prompted the World Health Organization (WHO) in 2011 to coin the slogan "No action today, no cure tomorrow" in order to immediately implement a new strategy to improve the use of available drugs and to accelerate the introduction of new ones through a new phase of research involving private and public institutions. The European Union has stressed that the surveillance is considered an essential factor for an effective response to this problem but it has also highlighted that the results produced have been lower than expectations because of serious shortcomings such as lack of methodological standards, insufficient data sharing and no coordination among European countries. In Italy the situation is much more troubling; in fact, according to the Ministry of Health, 5000-7000 yearly deaths are deemed due to nosocomial infections, with an annual cost of more than 100 million €.These figures explain how the fight against infections is far from being won. The purpose of this review is to analyze the basic causes of the recurrence of the phenomenon, to explain the steps taken by the most important international organizations to face AMR and finally to suggest a possible way to search for new classes of antibiotics.

Antibiotic resistance in the environment: expert perspectives -- Antibiotic resistant bacteria in wildlife -- Genomic surveillance for One Health antimicrobial resistance: understanding human, animal, and environmental reservoirs and transmission -- Antibiotic resistance in pharmaceutical industry effluents and effluent-impacted environments -- Antibiotic resistance in municipal wastewater: A special focus on hospital effluents -- Control strategies to combat dissemination of antibiotic resistance in urban water systems -- Antibiotic resistance, sanitation and public health -- Antibiotic resistance and sanitation in India: current situation and future perspectives -- Mitigating antimicrobial resistance risks when using reclaimed municipal wastewater for agriculture -- Antibiotic resistance in soil -- Religious Mass Gathering (Hajj) and Antimicrobial Resistance: From Challenges to Opportunities -- Human movement and transmission of anti-microbial resistant bacteria.

Bacteria have an enormous genetic plasticity and adaptive potential that enables them toinhabit almost every ecological niche on this planet and respond to drastic environmental changes. While this bacterial diversity and flexibility is highly fascinating and provides us with immense resources, it can also put human health at risk, e.g. when pathogenic bacteria adapt to antibiotics and become resistant. As antibiotic resistant bacteria increase human morbidity and mortality it is crucial to take action. The antibiotic resistance crisis is addressed on multiple levels including governmental and non-governmental programs, education, public health campaigns as well as academic and industrial research in epidemiology, medicine, pharmacology,biology and chemistry. The work conductedin this thesis contributes to the antibiotic resistance research by providing novel tools to studyde novo antibiotic resistance evolution in a more systematic and high-throughput fashion. Moreover, these tools were utilized to characterize the genetic trajectories of de novo antibiotic resistance evolution,predominantly in the model organism Escherichiacoli. Genetic constrains were identified, like negative epistatic interactions between different resistance modes or collateral sensitivity, and subsequently exploited by creating a framework to rationally design drug combinations inorder to limit de novo resistance evolution. Finally, limitations in efficiency and geneticresponses to novel CRISPR-based antimicrobials were studied and based on the findings factors crucial to optimize killing efficiency were identified. In short, this thesis contributes to our understanding of antibiotic resistance evolution, providing suggestions for novel and improved treatment options that likely contribute to limiting resistance evolution and treatment of resistant bacteria

Beginning in the 1940s, mass production of antibiotics involved the industrial-scale growth of microorganisms to harvest their metabolic products. Unfortunately, the use of antibiotics selects for resistance at answering scale. The turn to the study of antibiotic resistance in microbiology and medicine is examined, focusing on the realization that individual therapies targeted at single pathogens in individual bodies are environmental events affecting bacterial evolution far beyond bodies. In turning to biological manifestations of antibiotic use, sciences fathom material outcomes of their own previous concepts. Archival work with stored soil and clinical samples produces a record described here as 'the biology of history': the physical registration of human history in bacterial life. This account thus foregrounds the importance of understanding both the materiality of history and the historicity of matter in theories and concepts of life today.

Work in our laboratory is supported by grants BIO2008-00090 from the Spanish Ministry of Science and Innovation and KBBE-227258 (BIOHYPO), HEALTH-F3-2011-282004 (EVOTAR), and HEALTH-F3-2010-241476 (PAR) from European Union. ; Peer reviewed ; Peer Reviewed

Zulqarnain Baloch,1,* Bilal Aslam,2,* Saima Muzammil,2 Mohsin Khurshid,3 Muhammad Hidayat Rasool,2 Ke Ma4 1College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; 2Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 3College of Allied Health Professionals, Directorate of Medical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 4College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China *These authors contributed equally to this work Abstract: Antibiotic therapy has a dual impact: wanted, in which it immediately inhibits the growth of bacteria and the unwanted, which is responsible for the evolution of antibiotic resistance. The dissociation of therapeutic effectiveness from the possible risk of the antibiotic resistance may be attained by taking the advantage of specific relations between these drugs, and the methods in which mutations associated with resistance against a specific antibiotic may modify these relations or it may increase the sensitivity of the bacterium to the other antibiotics. Although the practical implementation of this notion needs considerable advancement and confirmation that depends upon the improvements in the field of genomics and diagnostics, these interventions propose new paradigms, which may confine or inverse the evolution of antibiotic resistance. Keywords: antibiotic resistance, inversion, mutations, bacteria, evolution

The fight against antibiotic resistance must be strengthened. We propose actions that U.S. government agencies and private sector entities can take to build a more comprehensive effort. These actions can increase the viability of investing in new antibiotics, ensure the quality and stewardship of all antibiotics, and make responses to emerging resistance more informed. Success requires the thoughtful exercise of federal authority and a firm commitment to share data and reward developers for the value generated with new, life-saving antibiotics.