4.1 What is AMR?

AMR occurs when microbes such as bacteria, viruses, fungi and parasites no longer respond to the drugs designed to kill them (UKRI, 2021).

Since the discovery of antimicrobials, starting in the early twentieth Century with the work of Erhlich and colleagues (identification of Salversan for syphilis) and Fleming (initial discovery of penicillin in 1928), millions of lives have been saved through successful treatment of infections. The emergence of resistance, that is, the ability of microbes to resist the action of antimicrobials, is a natural phenomenon which protects microbes from hostile environments. Unfortunately, due to the overuse and misuse of antimicrobials in human, animal and agricultural health sectors, we now see an acceleration in the prevalence of resistant microbes globally. For the purposes of this module, we will be focusing on AMR in bacteria.

AMR is recognised as a serious global threat to health, affecting humans, animals and plants. Surveillance of AMR is crucial to track changes in the incidence and prevalence of AMR at local (for example, community), national (countrywide) and global levels. An AMR surveillance system is defined as ‘a structured and systematic procedure to measure the prevalence or incidence of AMR through continuous or periodical surveillance performed with a defined methodology and with specified indicators’ (Dunne et al., 2000).