Plos Biology, June 2005
Inhibition of Mutation and Combating the Evolution of Antibiotic Resistance
The worldwide emergence of antibiotic-resistant bacteria threatens to undo the dramatic advances in human health that were ushered in with the discovery of these drugs in the mid-1900s. Today, resistance has rendered most of the original antibiotics obsolete for many infections, mandating an increased reliance on synthetic drugs. However, bacteria also evolve resistance to these drugs, typically by acquiring chromosomal mutations [1–6]. Within the classical paradigm that mutations are the inevitable consequence of replicating a large genome with polymerases of finite fidelity, resistance-conferring mutations are unavoidable. However, recent evidence suggests that bacteria may play a more active role in the mutation of their own genomes in response to at least some DNA-damaging agents by inducing proteins that actually promote mutation [7–15]. If the acquisition of antibiotic resistance-conferring mutations also requires the induction of these proteins, then their inhibition would represent a novel approach to combating the growing problem of drug resistance.

New England Journal of Medicine, April 7, 2005
Methicillin-Resistant Staphylococcus aureus Disease in Three Communities
Background Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. The national burden and clinical effect of this novel presentation of MRSA disease are unclear. Methods We evaluated MRSA infections in patients identified from population-based surveillance in Baltimore and Atlanta and from hospital-laboratory–based sentinel surveillance of 12 hospitals in Minnesota. Information was obtained by interviewing patients and by reviewing their medical records. Infections were classified as community-acquired MRSA disease if no established risk factors were identified.

New England Journal of Medicine, April 7, 2005
Necrotizing Fasciitis Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in Los Angeles
Background: Necrotizing fasciitis is a life-threatening infection requiring urgent surgical and medical therapy. Staphylococcus aureus has been a very uncommon cause of necrotizing fasciitis, but we have recently noted an alarming number of these infections caused by community-associated methicillin-resistant S. aureus (MRSA). Methods: We reviewed the records of 843 patients whose wound cultures grew MRSA at our center from January 15, 2003, to April 15, 2004. Among this cohort, 14 were identified as patients presenting from the community with clinical and intraoperative findings of necrotizing fasciitis, necrotizing myositis, or both. 

KQED Public Radio, January 20, 2005
Antibiotics
Antibiotics have been called wonder drugs because of their effectiveness against some of the world's deadliest diseases. But overuse has caused a growing problem of antibiotic resistance. We'll explore efforts to cut back on their use, both in humans and in farm animals. Also, we'll take a look at why there are so few new antibiotics in the pharmaceutical pipeline and the potential health crisis that looms ahead.

NPR Public Radio, October 29, 2004
Examining Antibiotic Resistance
We look at the problem of antibiotic resistant bacteria. Are researchers and manufacturers doing enough to develop new angles of attack against these medical threats?

Infectious Diseases Society of America, July, 2004
Bad Bugs, No Drugs Executive Summary
The purpose of this document is to call attention to a frightening twist in the antibiotic resistance problem that has not received adequate attention from federal policymakers: The pharmaceutical pipeline for new antibiotics is drying up.  Full report with recommendations to the US Congress (click the "download whitepaper" link).

Infectious Diseases Society of America, July, 2004
Urge Legislators to Spur Antibiotic R&D, Avert Public Health Crisis
Drug companies are withdrawing from antibiotic development due to unique challenges in this area of medicine. As a result, there is a dwindling supply of antibiotics available to treat patients with potentially life-threatening drug-resistant infections.  Many policymakers, including Members of Congress, are not aware of this brewing crisis or its implications for patient care, public health and national security.

National Institute of Allergy and Infectious Diseases, April 2004
The Problem of Antibiotic Resistance
antibiotic resistance has been a problem for nearly as long as we've been using antibiotics. Not long after the introduction of penicillin, a bacterium known as Staphylococcus aureus began developing penicillin-resistant strains. Today, antibiotic-resistant strains of S. aureus bacteria as well as various enterococci-bacteria that colonize the intestines-are common and pose a global health problem in hospitals. More and more hospital-acquired infections are resistant to the most powerful antibiotics available, methicillin and vancomycin. These drugs are reserved to treat only the most intractable infections in order to slow development of resistance to them.

Medical Journal of Australia, 2004
The dearth of new antibiotic development: why we should be worried and what we can do about it

• The emergence and spread of multidrug-resistant pathogens has increased substantially over the past 20 years.
• Over the same period, the development of new antibiotics has decreased alarmingly, with many pharmaceutical companies pulling out of antibiotic research in favour of developing “lifestyle” drugs.
• Reasons given for withdrawing from antibiotic development include poor “net present value” status of antibiotics, changes in regulations requiring larger drug trials and prolonged post-marketing surveillance, clinical preference for narrow-spectrum rather than broad-spectrum agents, and high new-drug purchase costs.
• Major improvements in infection control in Australia are needed to prevent further spread of resistant clones, buying some time to develop urgently needed new antibiotic agents.
• Perpetuating a culture of “pharma bashing” will simply lead to more pharmaceutical companies withdrawing from the market. A change in the health and research culture is needed to improve cooperation between public, academic and private sectors.

Annals of Internal Medicine, April, 1993
Resistance to Antimicrobial Drugs--A Worldwide Calamity
Resistant bacterial strains have emerged and have spread throughout the world because of the remarkable genetic plasticity of the microorganisms, heavy selective pressures of use, and the mobility of the world population. New and more expensive drugs have appeared almost in the nick of time, but it is doubtful that they will keep pace. The problem of resistance to antimicrobial drugs is particularly troublesome in developing countries. The underlying problems are largely economic and societal, and no ready solutions are available.

Aware - a Project of the California Medical Association 

CDC - Antimicrobal Resistance
CDC - Antibiotic Resistance
CDC - Spotlight on Community-Associated MRSA

CDER (FDA)  - Antimicrobal Resistance

Consumers Union

National Necrotizing Fasciitis Foundation

Foot Health Foundation of America
Diabetic Foot Statistics

Malaria Foundation (Press Releases)

ORSA - Oxacillin Resistant Staphylococcus Aureus

Pan American Health Organization - Antimicrobal Resistance
Curable diseases – from sore throats and ear infections to TB and malaria -- are in danger of becoming incurable. New report warns that increasing drug resistance could rob the world of its opportunity to cure illnesses and stop epidemics.

Pets-MRSA
information webiste based on up to date research that informs the public and veterinary profession about the risks of mrsa in companion animals.

Rehydrate.org - Rehydration Project

VRSA
Interim Guidelines for Prevention and Control of Staphylococcal Infection Associated with Reduced Susceptibility to Vancomycin

World Health Organization - Drug Resistance

Georgia Department of Human Resources, Division of Public Health
Methicillin-Resistant Staphylococcus aureus (MRSA)has emerged as a serious threat in the community. Until recently, MRSA was seen almost exclusively in hospitalized patients. Because we are now seeing it in the community, especially in pockets such as groups of athletes, children in childcare settings and crowding situations such as prisons and jails, the Georgia Division of Public Health is working to educate the public to prevent this threatening infection. Click on the following links to get current information on MRSA:

• MRSA Fact Sheet
• MRSA Update
• MRSA Brochure
• MRSA Prevention Poster

KPBS / NPR, June 2006
PBS Documentary on Superbugs

If you get sick with a bacterial infection this year, antibiotics from your doctor may not be a fool-proof answer.

We discuss the serious medical problem of antibiotic resistance. Then, we explore the obstacles to new antibiotic development and what this means for public health. Then, a one-on-one interview with NPR Senior News Analyst Cokie Roberts (unrelated topic).