first report to find NDM-1 in environmental samples unconnected to hospitals or
infected patients...across New Delhi, a city with 21 million inhabitants.”- “In terms of resistance, the part of the iceberg that’s important is what we don’t
see in hospitals-and in India, that part is absolutely massive.”
Magiorakos, A.-P., Srinivasan, A., Carey, R. B., et al. (2012). Multidrug-resistant,
extensively drug-resistant and pandrug-resistant bacteria: an international expert
proposal for interim standard definitions for acquired resistance. European Society of
Clinical Microbiology and Infectious Diseases. (18). pg. 268-81.
http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)61632-3/pdf
- “Many different definitions for multidrug-resistant (MDR), extensively drug-
resistant (XDR) and pandrug-resistant (PDR) bacteria are being used in the
medical literature to characterize the different patterns of resistance found in
healthcare-associated, antimicrobial-resistant bacteria.” - “A group of international experts came together through a joint initiative by the
European Centre for Disease Prevention and Control (ECDC) and the Centers for
Disease Control and Prevention (CDC), to create a standardized international
terminology with which to describe acquired resistance profiles.” - “MDR was defined as acquired non0susceptibility to at least one agent in three
or more antimicrobial categories, XDR was defined as non-susceptibility to at
least one agent in all but two or fewer antimicrobial categories (i.e. bacterial
isolates remain susceptible to only one or two categories) and PDR was defined
as non-susceptibility to all agents in all antimicrobial categories.”
Martinez, J. L. (2008). Antibiotics and antibiotic resistance genes in natural
environments. Science. 321(5887). pg. 365-7.
http://www.ncbi.nlm.nih.gov/pubmed/18635792
Martinez, J. L. (2009). Environmental pollution by antibiotics and by antibiotic
resistance determinants. Environmental Pollution. 157(11). pg. 2893-902.
http://www.ncbi.nlm.nih.gov/pubmed/19560847
- “Antibiotics are extensively used for animal farming and for agricultural
purposes. Residues from human environments and from farms may contain
antibiotics and antibiotic resistance genes that can contaminate natural
environments.” - “The clearest consequence of antibiotic release in natural environments is the
selection of resistant bacteria. The same resistance genes found at clinical
settings are currently disseminated among pristine ecosystems without any
record of antibiotic contamination.”