Antibiotic Resistance is a Tragedy of the Commons That Necessitates Global Cooperation

2015 ◽  
Vol 43 (S3) ◽  
pp. 33-37 ◽  
Author(s):  
Aidan Hollis ◽  
Peter Maybarduk
Keyword(s):  
Antibiotic Resistance ◽  
Selection Pressure ◽  
Tragedy Of The Commons ◽  
Public Access ◽  
Resistant Bacteria ◽  
The Commons

Antibiotic resistance presents a classic example of the “tragedy of the commons.” In this eponymous tragedy, the commons — shared, public access lands — are overgrazed because farmers can send their livestock onto the land at a zero price. The “tragedy” occurs because overgrazing destroys the land and reduces its ability to provide fodder. The application to antibiotics is obvious: the use of antibiotics creates selection pressure leading to increased proportions of resistant bacteria in the patient and the environment. The increase in frequency of resistant organisms diminishes the effectiveness of antibiotics in treating future infections; thus, the long-term value of the antimicrobial resource is reduced.

The Effect of Incentives: Diffusion of Responsibility

2021 ◽  
pp. 166-182
Author(s):  
Jason Brennan ◽  
William English ◽  
John Hasnas ◽  
Peter Jaworski
Keyword(s):  
Climate Change ◽  
Collective Action ◽  
Tragedy Of The Commons ◽  
Short Term ◽  
Collective Action Problem ◽  
P Diffusion ◽  
Perverse Incentives ◽  
The Commons ◽  
Diffusion Of Responsibility

Diffusion of responsibility refers to the problem that when something is everyone’s job, it in effect ends up being nobody’s job. This explains why many collective problems arise. People face perverse incentives to free ride on others’ actions and not to do their part. As a result, agents often think in short-term rather than long-term ways. Problems such as climate change can be modeled as instances of the tragedy of the commons, one form of a collective action problem that arises due to perverse incentives created by the diffusion of responsibility.

scholarly journals Plasmid Dynamics in KPC-Positive Klebsiella pneumoniae during Long-Term Patient Colonization

mBio ◽  
2016 ◽  
Vol 7 (3) ◽  
Author(s):  
Sean Conlan ◽  
Morgan Park ◽  
Clayton Deming ◽  
Pamela J. Thomas ◽  
Alice C. Young ◽  
...  
Keyword(s):  
Health Care ◽  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Health Care Facilities ◽  
Resistant Bacteria ◽  
Whole Genome ◽  
Antibiotic Resistant ◽  
Carbapenem Resistant ◽  
Clinical Center

ABSTRACT Carbapenem-resistant Klebsiella pneumoniae strains are formidable hospital pathogens that pose a serious threat to patients around the globe due to a rising incidence in health care facilities, high mortality rates associated with infection, and potential to spread antibiotic resistance to other bacterial species, such as Escherichia coli . Over 6 months in 2011, 17 patients at the National Institutes of Health (NIH) Clinical Center became colonized with a highly virulent, transmissible carbapenem-resistant strain of K. pneumoniae . Our real-time genomic sequencing tracked patient-to-patient routes of transmission and informed epidemiologists’ actions to monitor and control this outbreak. Two of these patients remained colonized with carbapenemase-producing organisms for at least 2 to 4 years, providing the opportunity to undertake a focused genomic study of long-term colonization with antibiotic-resistant bacteria. Whole-genome sequencing studies shed light on the underlying complex microbial colonization, including mixed or evolving bacterial populations and gain or loss of plasmids. Isolates from NIH patient 15 showed complex plasmid rearrangements, leaving the chromosome and the bla KPC -carrying plasmid intact but rearranging the two other plasmids of this outbreak strain. NIH patient 16 has shown continuous colonization with bla KPC -positive organisms across multiple time points spanning 2011 to 2015. Genomic studies defined a complex pattern of succession and plasmid transmission across two different K. pneumoniae sequence types and an E. coli isolate. These findings demonstrate the utility of genomic methods for understanding strain succession, genome plasticity, and long-term carriage of antibiotic-resistant organisms. IMPORTANCE In 2011, the NIH Clinical Center had a nosocomial outbreak involving 19 patients who became colonized or infected with bla KPC -positive Klebsiella pneumoniae . Patients who have intestinal colonization with bla KPC -positive K. pneumoniae are at risk for developing infections that are difficult or nearly impossible to treat with existing antibiotic options. Two of those patients remained colonized with bla KPC -positive Klebsiella pneumoniae for over a year, leading to the initiation of a detailed genomic analysis exploring mixed colonization, plasmid recombination, and plasmid diversification. Whole-genome sequence analysis identified a variety of changes, both subtle and large, in the bla KPC -positive organisms. Long-term colonization of patients with bla KPC -positive Klebsiella pneumoniae creates new opportunities for horizontal gene transfer of plasmids encoding antibiotic resistance genes and poses complications for the delivery of health care.

scholarly journals Fecal pollution explains antibiotic resistance gene abundances in anthropogenically impacted environments

2018 ◽  
Author(s):  
Karkman Antti ◽  
Pärnänen Katariina ◽  
Larsson D.G. Joakim
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Gene ◽  
Resistance Genes ◽  
Selection Pressure ◽  
Pathogenic Bacteria ◽  
Antibiotic Resistance Gene ◽  
Fecal Pollution ◽  
Metagenomic Data ◽  
Resistant Bacteria ◽  
Environmental Selection

AbstractDischarge of treated sewage leads to release of antibiotic resistant bacteria, resistance genes and antibiotic residues to the environment. Such pollution can directly contribute to increased morbidity caused by the transmission of resistant fecal pathogens. Residual antibiotics in wastewaters have been speculated to select for resistant bacteria and thereby promote the evolution and emergence of new resistance factors. Increased abundance of antibiotic resistance genes in sewage and sewage-impacted environments may, however, simply be a result of fecal contamination with resistant bacteria rather than caused by an on-site selection pressure. In this study we have disentangled these two alternative scenarios by relating the relative resistance gene abundance to the accompanying extent of fecal pollution in publicly available metagenomic data. This was possible by analyzing the abundance of a newly discovered phage which is exceptionally abundant in, and specific to, human feces. The presence of resistance genes could largely be explained by fecal pollution, with no clear signs of selection in the environment, the only exception being environments polluted by very high levels of antibiotics from manufacturing where selection is evident. Our results demonstrate the necessity to take in to account the fecal pollution levels to avoid making erroneous assumptions regarding environmental selection of antibiotic resistance. The presence or absence of selection pressure has major implications for what the risk scenarios are (transmission versus evolution) and for what mitigations (reducing pathogenic bacteria or selective agents) should be prioritized to reduce health risks related to antibiotic resistance in the environment.

scholarly journals A trimethoprim derivative impedes antibiotic resistance evolution

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Madhu Sudan Manna ◽  
Yusuf Talha Tamer ◽  
Ilona Gaszek ◽  
Nicole Poulides ◽  
Ayesha Ahmed ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistant Bacteria ◽  
Gene Encoding ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Resistance Evolution ◽  
Evolutionary Trajectories ◽  
Evolution Of Resistance

AbstractThe antibiotic trimethoprim (TMP) is used to treat a variety of Escherichia coli infections, but its efficacy is limited by the rapid emergence of TMP-resistant bacteria. Previous laboratory evolution experiments have identified resistance-conferring mutations in the gene encoding the TMP target, bacterial dihydrofolate reductase (DHFR), in particular mutation L28R. Here, we show that 4’-desmethyltrimethoprim (4’-DTMP) inhibits both DHFR and its L28R variant, and selects against the emergence of TMP-resistant bacteria that carry the L28R mutation in laboratory experiments. Furthermore, antibiotic-sensitive E. coli populations acquire antibiotic resistance at a substantially slower rate when grown in the presence of 4’-DTMP than in the presence of TMP. We find that 4’-DTMP impedes evolution of resistance by selecting against resistant genotypes with the L28R mutation and diverting genetic trajectories to other resistance-conferring DHFR mutations with catalytic deficiencies. Our results demonstrate how a detailed characterization of resistance-conferring mutations in a target enzyme can help identify potential drugs against antibiotic-resistant bacteria, which may ultimately increase long-term efficacy of antimicrobial therapies by modulating evolutionary trajectories that lead to resistance.

scholarly journals The Tragedy of the Risk Averse

Erkenntnis ◽  
2020 ◽  
Author(s):  
H. Orri Stefánsson
Keyword(s):  
Decision Problem ◽  
Tragedy Of The Commons ◽  
Noncooperative Game ◽  
Time Slice ◽  
Risk Averse ◽  
Rational Person ◽  
The Future ◽  
The Commons

AbstractThose who are risk averse with respect to money, and thus turn down some gambles with positive monetary expectations, are nevertheless often willing to accept bundles involving multiple such gambles. Therefore, it might seem that such people should become more willing to accept a risky but favourable gamble if they put it in context with the collection of gambles that they predict they will be faced with in the future. However, it turns out that when a risk averse person adopts the long-term perspective, she faces a decision-problem that can be analysed as a noncooperative game between different “time-slices” of herself, where it is in the interest of each time-slice (given its prediction about other slices) to turn down the gamble with which it is faced. Hence, even if a risk averse but rational person manages to take the long-term perspective, she will, in the absence of what Hardin called “mutual coercion”, end up in a situation analogous to the “tragedy of the commons”.

scholarly journals Triumph of the Commons: Sustainable Community Practices on Rapa Nui (Easter Island)

2021 ◽  
Vol 13 (21) ◽  
pp. 12118
Author(s):  
Robert J. DiNapoli ◽  
Carl P. Lipo ◽  
Terry L. Hunt
Keyword(s):  
Large Scale ◽  
18Th Century ◽  
Tragedy Of The Commons ◽  
Easter Island ◽  
Rapa Nui ◽  
Ecological Changes ◽  
History Of ◽  
The Commons ◽  
Past Land Use

The history of Rapa Nui (Easter Island) has long been framed as a parable for how societies can fail catastrophically due to the selfish actions of individuals and a failure to wisely manage common-pool resources. While originating in the interpretations made by 18th-century visitors to the island, 20th-century scholars recast this narrative as a “tragedy of the commons,” assuming that past populations were unsustainable and selfishly overexploited the limited resources on the island. This narrative, however, is now at odds with a range of archaeological, ethnohistoric, and environmental evidence. Here, we argue that while Rapa Nui did experience large-scale deforestation and ecological changes, these must be contextualized given past land-use practices on the island. We provide a synthesis of this evidence, showing that Rapa Nui populations were sustainable and avoided a tragedy of the commons through a variety of community practices. We discuss this evidence in the context of Elinor Ostrom’s “core design principles” for sustainable communities and argue that Rapa Nui provides a model for long-term sustainability.

scholarly journals Exposure to environmental level pesticides stimulates and diversifies evolution inEscherichia colitowards greater antibiotic resistance

2019 ◽  
Author(s):  
Yue Xing ◽  
Shuaiqi Wu ◽  
Yujie Men
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Molecular Mechanisms ◽  
Municipal Wastewater ◽  
Resistant Bacteria ◽  
Comparative Genomic ◽  
Emerging Organic Contaminants ◽  
Environmental Level ◽  
Selection Of

AbstractAntibiotic resistance is one of the most challenging issues in public health. Antibiotic resistance can be selected by antibiotics at sub-inhibitory concentrations, the concentrations typically occurring in natural and engineered environments. Meanwhile, many other emerging organic contaminants such as pesticides are frequently co-occurring with antibiotics in agriculture-related environments and municipal wastewater treatment plants. To investigate the effects of the co-existing, non-antibiotic pesticides on the development of antibiotic resistance, we conducted long-term exposure experiments using a modelEscherichia colistrain. The results revealed that 1) the exposure to a high level (in mg/L) of pesticides alone led to the emergence of mutants with significantly higher resistance to streptomycin; 2) the exposure to an environmental level (in µg/L) of pesticides together with a sub-inhibitory level (in sub mg/L) of ampicillin synergistically stimulated the selection of ampicillin resistance and the cross-selection of resistance to three other antibiotics (i.e., ciprofloxacin, chloramphenicol, and tetracycline). Resistance levels of mutants selected from co-exposure were significantly higher than those of mutants selected from ampicillin exposure only. The comparative genomic and transcriptomic analyses indicate that distinct and diversified genetic mutations in ampicillin- and ciprofloxacin-resistant mutants were selected from co-exposure, which likely caused holistic transcriptional regulation and the increased antibiotic resistance. Together, the findings provide valuable fundamental insights into the development of antibiotic resistance under environmentally relevant conditions, as well as the underlying molecular mechanisms of the elevated antibiotic resistance induced by the exposure to pesticides.Significance statementAntibiotic resistance is a major threat to public health globally. Besides clinically relevant environments, the emergence and spread of resistant bacteria in non-clinical environments can also potentially pose risks of therapy failures. This study showed that the long-term, environment-level exposure to pesticides with and without antibiotics significantly stimulated the development of greater antibiotic resistance. The resistant strains selected from the exposure to pesticides are genetically and metabolically distinct from the ones selected by the antibiotic only. Although it is still being debated regarding whether or not a large use of antibiotics in plant agriculture is harmful, our findings provide the first fundamental evidence that greater concerns of antibiotic resistance may result if antibiotics are applied together with non-antibiotic pesticides.

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