Many diseases are caused by pathogenic bacteria and other microbes. These diseases include various epidemic illnesses and also tuberculosis, pneumonia, blood infection (sepsis), leprosy, and syphilis. Antibiotics are chemicals toxic to such microbes. Antimicrobial drug resistance results from the rapid ability of microbes to reproduce and so evolve strains resistant to antibiotics. The use of antibiotics actually speeds up the process of adaptation; therefore, microbial drug resistance is not a passing trend but likely a permanent feature in the fight against infectious diseases.
Across the world, people are dying as result of infections which do not respond to any of the 160 different antibiotics on the market. Acute infectious diseases are re-emerging as a serious threat to health in advanced industrialized countries due to the growing resistance of microbes to antibiotic drugs. Organisms in which resistance is a serious problem include Streptococci spp, Staphylococci spp, Enterococci spp, Pseudomonas spp, and Mycobacterium tuberculosis. Staphylococcus aureus has become legendary for its ability to collect resistance traits against antibacterial agents and strains have become endemic in hospitals that are resistant to vancomycin, the antibiotic of last resort. VRE, a form of Enterococcus faecium, which causes wound and urinary tract infections, is also resistant to vancomycin.
Drug-resistant strains of tuberculosis have appeared in many places throughout the world in the last 50 years, including the USA, Russia and Azerbaijan. In Russia in 1997, drug-resistant tubercular cases spread into the population at large, as some of Russia's 1 million prisoners were released from overcrowded jails, where disease spreads readily. While the official toll is 2481 cases per 100,000 prisoners, unofficially the incidence is 50%. The incidence of TB in the Russian non-prison population has tripled to 70 cases per 100,000. In Azerbaijan there are officially 4667 TB cases per 100,000 prisoners, of whom one quarter die. 56,000 prisoners were released in 1996, many of whom were known to be suffering from drug-resistant TB. In Russia and Azerbaijan the prevalence of TB is also rising to the levels of the 1970's. This, poverty due to economic upheaval, and a lack of medical services, have contributed to Russia's mortality rate, now the highest in Europe. In the USA there are 8.7 TB cases per 100,000 people.
Drug resistance is regarded as the key driver of the increased sales of antibiotics, following a slump in the 1980s. The worldwide market for antibiotics was worth $20 billion in 1991, 12% up on 1990. Estimates of the total cost of antibiotic resistance in the USA range up to $30 billion a year.
Russian public health would benefit more if infected prisoners were let die rather than giving them partial drug treatment which builds up resistance to the disease. Some patients have acquired resistance to all drugs currently in use.