The health care system is challenged by another serious issue: antimicrobial resistance. Clostridium difficile is the most common infection in health care institutions and is becoming resistant to standard treatment. Carbapenem-resistant enterobacteriaceae can be found in almost every state in the United States. Confounding the antimicrobial resistance issue is the fact that few new antimicrobials are being developed by pharmaceutical companies. The situation is so critical that the White House issued a strategic plan in September 2014 to deal with antimicrobial resistance. One challenge in that plan is to better understand how microbes have become resistant. Microbes have developed defense mechanisms such as bacteriophages and bacteriocins to survive for thousands of years. If science can start to use these mechanisms to help combat resistant organisms in combination with antimicrobials and strong epidemiological interventions, the battle against antimicrobial resistance may succeed.

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