Chapter 1 The Marine Ecosystem as a Source of Antibiotics Yuly López, Virginio Cepas, and Sara M. Soto 1 Introduction In spite of the remarkable impact on health that the antimicrobials have achieved in the 1960s and 1970s, 40 years later infectious diseases remain the second-leading cause of death worldwide [1]. Nowadays, one of the most important health problems is the increase, emergence, and spread of antimicrobial resistance among the different microorganisms (bacteria, fungi, virus, and parasites). In the case of bacteria, resistance to antibiotics is increasing in both community and hospital settings in association with an increase in mortality and morbidity. As shown in Fig. 1.1, the discovery of new antibiotics with new mechanisms of action slowed in the year 1968 after the discovery of cephalosporins [2]. After that, most of the antibiotics developed belonged to the existing classes and were considered as “new generations.” Unfortunately, the development of an antibiotic has, sooner or later, been followed by the emergence of bacterial strains resistant to these antibiotics. Fig- ure 1.1 shows several examples of this [3]: – In the 1940s penicillin was introduced into the clinical setting. Yet, in the mid-1940s, the first Staphylococcus aureus strains producing penicillinases resis- tant to penicillin were identified. – In the 1950s, aminoglycoside, chloramphenicol, tetracycline, and macrolides were developed, with multiresistant strains of S. aureus emerging within the same decade. Y. López · V. Cepas · S. M. Soto (*) ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain e-mail:
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