1. 1
It is not difficult to make
microbes resistant to
penicillin in the laboratory,
and the same has occasionally
happened in the body.
The End of Modern Medicine?
Alexander Fleming, 1945
Nobel Prize Acceptance Speech
2. Animal
feeds
2 Antimicrobial resistance
lakes Swim
Hospital Care
facilities
HUMANS
Urban
areas
Rural
areas
Vegetables, seed
crops, fruits &
vegetables
Irrigation
water
AQUACULTURE Seas &
Soil
WILDLIFE
Sewage
Drinking
water
Rivers &
streams
Handling,
preparation,
consumption
Meat &
fish
Commercial
abattoirs &
processing
plants
COMPANION
ANIMALS
Direct contact
Drinking
water
Farm effluents &
manure spreading
Rendering Dead Offal
stock
Swine
FOOD
ANIMALS
Sheep Cattle
Poultry Others
Industrial &
household
antimicrobial
chemicals
Antibiotics
Antibiotics
Food processing
antimicrobials
Epidemiol
ogy
of AMR
Diagram based on Linton (1977), as adapted by Rebecca Irwin, Health Canada (Prescott 2000) and IFT
3. 3
Economic costs
Russia
83% of families use unnecessary
antibiotics at home
Antimicrobial resistance Map and statistics from World Economic Forum “Global Risks 2013”
except UK statistics, which are based on work published by Richard Smith of LSHTM
Europe – cost of AMR
€1.5bn and 600m lost days of
producUtivKity –p ecr oyesatr of AMR
£10bn/yr societal costs plus
£20k per patient episode
USA – cost of AMR
Healthcare costs alone
$21-34bn/yr
Japan and Antarctica
Resistant bacteria found in
water samples
