Genes, guts and globalisation

Research output: Contribution to journalArticlepeer-review


Colleges, School and Institutes


The widespread use of antibacterial drugs over the last 70 years has brought
immense benefits to human health at the price of increasing drug inefficacy.
Antibacterial agents have a strong selective effect in both favouring resistant strains and allowing particular species and families of bacteria to prosper, especially in the healthcare setting. Whilst important gram positive bacterial pathogens such as Staphylococcus aureus and Streptococcus pneumoniae caused concern over the last 20 years because of the spread of antibiotic resistant strains, Enterobacteriacae have become the biggest challenge. They have very efficient mechanisms for genetic exchange as illustrated by the emergence and rapid spread of CTX-M betalactamases and the carbapenemases. The unique epidemiology of Enterobacteriacae with substantial numbers colonising the mammalian gut and subsequent release into and spread in the environment presents a significant threat to human health because of the high levels of exposure for the whole community. The use of antimicrobials in agriculture combined with global movements of people, animals and food arising from worldwide industrialisation generates a diversity and level of resistance not seen previously. Control will require globally co-ordinated
interventions similar to those needed to ameliorate climate change.


Original languageEnglish
Pages (from-to)2589-2600
Number of pages2600
JournalJournal of Antimicrobial Chemotherapy
Early online date1 Aug 2018
Publication statusPublished - 1 Oct 2018