Confronting the challenge of antimicrobial ...( Drug resistance is making many disea...),Health

Drug resistance is making many diseases increasingly difficult--and sometimes impossible--to treat, according to Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Extensively drug-resistant tuberculosis and invasive methicillin-resistant Staphylococcus aureus (MRSA) infections are just two recent examples of this problem that pose serious threats to domestic and global health, he adds. In a new report in the Journal of Infectious Diseases, now available online, Dr. Fauci outlines NIAIDs commitment to addressing this urgent public health issue.

The innate ability of microbes to evade containment and destruction by drugs through rapid reproduction and genetic mutation is exacerbated by the overuse and misuse of existing antimicrobial drugs, Dr. Fauci and his coauthors note. Other factors contributing to the upswing in drug resistance include a dearth of rapid diagnostic tests that would allow physicians to better gauge whether a given infection is drug-susceptible or drug-resistant, and a paucity of clinical trial data to guide therapeutic strategies.

NIAID is meeting the complex challenge of antimicrobial resistance through a multifaceted research approach that includes partnerships with other federal agencies, academia, industry and non-governmental organizations, the authors report. In fiscal year 2007, NIAID invested more than $800 million to support basic and translational research on antimicrobials, more than $200 million of which was devoted to understanding the causes, consequences and treatments of antimicrobial drug resistance.

Basic research projects under way at NIAID or in NIAID-supported labs across the country include the following:

• Investigations of mechanisms of resistance and how these traits are acquired and passed on by microbes

• Research on factors that contribute to the virulence of pa
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