World J Clin Infect Dis 2011 December 30; 1(1): 11-16 ISSN 2220-3176 (online) © 2011 Baishideng. All rights reserved. Online Submissions: http://www.wjgnet.com/2220-3176ofice wjcid@wjgnet.com doi:10.5495/wjcid.v1.i1.11 World Journal of Clinical Infectious Diseases WJC I D Antibiotic-resistant bugs in the 21st century: A public health challenge Samuel S Taiwo Samuel S Taiwo, Department of Medical Microbiology, College of Health Sciences, Ladoke Akintola University of Technology and Teaching Hospital, Ogbomoso, 23400001, Nigeria Author contributions: Taiwo SS solely contributed to this paper Correspondence to: Samuel S Taiwo, MBBS, FMCPath, As- sociate Professor, Head, Department of Medical Microbiology, College of Health Sciences, Ladoke Akintola University of Tech- nology and Teaching Hospital, Ogbomoso, 23400001, Nigeria. samtaiwo2003@yahoo.com Telephone: +234-80-33436344 Fax: +234-80-33436344 Received: July 12, 2011 Revised: October 20, 2011 Accepted: December 23, 2011 Published online: December 30, 2011 Abstract Antimicrobial resistance, which has been reported against almost every antibiotic discovered, is one of the most urgent public health problems, threatening to undermine the effectiveness of infectious disease treat- ment worldwide. Since penicillin ushered in the antibi- otic era in the mid 20th century, the scientiic world had engaged in a war between the development of antibac- terial agents and bacterial resistance. During the irst decade of the 21st century, grave concern has been expressed over the evolution of multi-drug resistant staphylococci, enterococci, and mycobacteria, which pose serious clinical and public health challenge to hu- mans. The present picture is frighteningly similar to the pre-antibiotic era, with reports of nosocomial spread and intercontinental dissemination of multi-drug resis- tant bacteria. For infected patients, there is no magic bullet. The microbial pathogens appear to be gaining the upper hand, coupled with a recent dramatic reduc- tion in antibiotic research by pharmaceutical companies because of the high cost of drug research. Several com- pounds that have recently been developed or resur- rected to treat gram-positive infections are still unable to meet the armamentarium of resistance mechanisms of these pathogens. The situation is worse for gram- negative organisms, where no new drug is currently being developed against them. A multi-disciplinary ap- proach to combat resistance is required, which must be applied, sustained, and continuously refined. The key components for maintaining effective antimicrobial chemotherapy will include better use of existing agents, coupled with continuous investment in new and innova- tive technologies, which must include diagnostics and vaccines in addition to new antimicrobial agents. © 2011 Baishideng. All rights reserved. Key words: Antimicrobial; Resistance; Bugs; Public health Peer reviewer: Zainab Al-Doori, BSc, PhD, Glasgow Caledo- nian University, Glasgow G68 0JA, Scotland Taiwo SS. Antibiotic-resistant bugs in the 21st century: A pub- lic health challenge. World J Clin Infect Dis 2011; 1(1): 11-16 Available from: URL: http://www.wjgnet.com/2220-3176/full/ v1/i1/11.htm DOI: http://dx.doi.org/10.5495/wjcid.v1.i1.11 INTRODUCTION The discovery and introduction of penicillin as a che- motherapeutic agent in the 1940s was greeted with great enthusiasm. A 33-year-old woman dying of a streptococ- cal blood stream infection in a New Haven Connecticut hospital in March 1942 was cured after careful injection of repeated doses of the “miracle” drug; she went on to live to the age of 90 [1] . The enthusiasm was short lived; in 1944, Staphylococcus aureus (S. aureus) resistant to penicillin through the production of β-lactamase enzyme emerged. Methicillin, a β-lactamase resistant penicillin, was intro- duced into the market in 1959, but in 1961, resistance to methicillin also emerged [2] . These strains of S. aureus called Methicillin Resistant Staphylococcus aureus (MRSA) became disseminated worldwide, irst as hospital-associated [3] , and later as community-associated, pathogens [4] . OBSERVATION 11 December 30, 2011|Volume 1|Issue 1| WJCID|www.wjgnet.com