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3.2 Microbial ecology and antimicrobials

There is an enormous number of microorganisms on earth and they form a vital part of a healthy ecosystem. Antimicrobials are medicines used that treat infections caused by microorganisms such as bacteria, fungi, viruses, and parasites.

AMR is a natural phenomenon that has evolved over evolutionary time, but also develops rapidly when microorganisms are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). New resistance mechanisms are emerging and spreading globally, threatening the ability to treat common infectious diseases, resulting in prolonged illness, disability, and death. Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery become very high risk (WHO, 2018)[2].

One type of AMR, specifically antibiotic resistance is an ancient phenomenon and even samples from permafrost, “pre-Antibiotic era” show resistance genes against modern antibiotics. There are two basic types of resistance: i) Intrinsic, where the resistance is usually related to structural features of the cell; ii) Acquired, where resistance is caused by mutation or acquisition of novel genes which can happen via a variety of mechanisms, together termed “horizontal gene transfer”.