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During 1997 an event doctors had been fearing finally occurred In three geographically separate patients an often deadly bacterium Staphylococcus aureus responded poorly to a once reliable antidote--the antibiotic vancomycin Fortunately in those patients the bacteria remained susceptible to other drugs and was eradicated But the appearance of S aureus not readily cleared by vancomycin foreshadows trouble Worldwide many strains of S aureus are already resistant to all antibiotics except vancomycin Emergence of forms lacking sensitivity to vancomycin signifies that variants untreatable by every known antibiotic are on their way S aureus a major cause of hospital-acquired infections has thus moved one step closer to becoming an unstoppable killer The looming threat of incurable S aureus is just the latest twist in an international public health nightmare increasing bacterial resistance to many antibiotics that once cured bacterial diseases readily Ever since antibiotics became widely available in the 1940s they have been hailed as miracle drugs -- magic bullets able to eliminate bacteria without doing much harm to the cells of treated individuals Yet with each passing decade bacteria that defy not only single but multiple antibiotics -- and therefore are extremely difficult to control -- have become increasingly common What is more strains of at least three bacterial species capable of causing life-threatening illnesses Enterococcus faecalis Mycobacterium tuberculosis and Pseudomonas aeruginosa already evade every antibiotic in the clinicians stockpile of more than 100 drugs In part because of the rise in resistance to antibiotics the death rates for some communicable diseases such as tuberculosis have started to rise again after having declined in the industrial nations How did we end up in this worrisome and worsening situation Several interacting processes are at fault Analyses of them point to a number of actions that could help reverse the trend if individuals businesses and governments around the world can find the will to implement them One component of the solution is recognizing
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