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Antibiotic Resistance: Origins, Evolution, Selection and Spread Chairman: Stuart B. Levy 1997 Over the last 50 years, the rapid increase in the use of antibiotics, not only in people, but also in animal husbandry and agriculture, has delivered a selection unprecedented in the history of evolution. Consequently, society is facing one of its gravest public health problems-the emergence of infectious bacteria with resistance to many, and in some cases all, available antibiotics. This book brings together a multidisciplinary group of experts to discuss this problem. It begins by examining the origins of resistance and goes on to look at how the use of antibiotics in human medicine and farming/agriculture has selected for resistant bacteria. Separate chapters describe the evolution of resistance determinants and how these are spread both within and between bacterial species. Finally, the book contains discussions on strategies for countering the threat of antibiotic resistance. A major re-thinking of our approach to the treatment of infectious diseases is proposed-that antibiotic resistance should be seen as a problem created by the disruption of normal microbial ecology. To restore efficacy to earlier antibiotics, and to maintain the success of new antibiotics that are introduced, we need to use these drugs in a way that ensures an ecological balance that favours the predominance of susceptible bacteria.

Drug resistance in microorganisms --- Antibiotics --- Drug Resistance, Microbial --- Congresses. --- pharmacology --- congresses. --- DRUG RESISTANCE, MICROBIAL --- ANTIBIOTICS --- DRUG RESIDUES --- BETA-LACTAM RESISTANCE --- TETRACYCLINE RESISTANCE --- ERYTHROMYCIN --- EPIDEMIOLOGY

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Streptococci and enterococci are the etiologic agents of infectious diseases that rank among the most severe in human pathology. The diagnosis, antibiotherapy, and prevention of the streptococcal diseases have improved considerably. However, the reemergence of severe streptococcal and enterococcal diseases constitutes a growing public health con­ cern, which remains open to scientific and medical debate. The XIII'h Lancefield International Symposium on Streptococci and Streptococcal Diseases, held at Institut Pasteur, Paris, France, September 16---2el, 1996, attracted 505 par­ ticipants from 43 countries. Twenty-two percent of the participants were students, a clear sign of the intense interest in this field. Of the 390 presentations made at the symposium, 260 were submitted as manuscripts for the Proceedings; we have included 249 of these in this volume. This symposium provided a forum for the presentation of the most recent findings and approaches to understanding several important fields, such as new aspects of infec­ tion, bacteria~host interactions, epidemiology, and molecular genetics of streptococci and enterococci. Over the last three years, the study of these subjects has expanded as increas­ ingly sophisticated methods of molecular analysis have been applied to investigate the bi­ ology of pathogenic streptococci and enterococci. Virulence, vaccine strategies, genetics, antibiotic resistance, epidemiology, and immunology are now being examined through the lens of molecular biology. The application of recently developed techniques to this field will continue to yield insight into the mechanism by which these organisms cause disease.

Streptococcal Infections --- Enterococcus --- Streptococcal infections --- Congresses --- Medical microbiology. --- Infectious diseases. --- Immunology. --- Medical Microbiology. --- Infectious Diseases. --- Immunobiology --- Life sciences --- Serology --- Strep infections --- Gram-positive bacterial infections --- Drug Resistance, Microbial. --- Immunity. --- Drug Resistance, Microbial --- Immunity --- Epidemiology --- Genes (microbial) --- Streptococcus --- Vaccines