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[[File:Antibiotic sensitivity and resistance.jpg|thumb|upright=1.4|[[Disk diffusion test|Antibiotic resistance tests]]: Bacteria are streaked on dishes with white disks, each impregnated with a different antibiotic. Clear rings, such as those on the left, show that bacteria have not grown—indicating that these bacteria are not resistant. The bacteria on the right are fully resistant to three of seven and partially resistant to two of seven antibiotics tested.<ref>[http://www.microbelibrary.org/component/resource/laboratory-test/3189-kirby-bauer-disk-diffusion-susceptibility-test-protocol Kirby-Bauer Disk Diffusion Susceptibility Test Protocol] {{webarchive|url=https://web.archive.org/web/20110626190940/http://www.microbelibrary.org/component/resource/laboratory-test/3189-kirby-bauer-disk-diffusion-susceptibility-test-protocol |date=26 June 2011 }}, Jan Hudzicki, ASM</ref>|alt=Two petri dishes with antibiotic resistance tests]]
'''Antimicrobial resistance''' ('''AMR''') occurs when [[microbe]]s evolve mechanisms that protect them from the effects of [[antimicrobials]] (drugs used to treat infections).<ref name="WHO2014">{{cite web|title=Antimicrobial resistance Fact sheet N°194|url=https://www.who.int/mediacentre/factsheets/fs194/en/|website=who.int|access-date=7 March 2015|date=April 2014|archive-url=https://web.archive.org/web/20150310081111/http://www.who.int/mediacentre/factsheets/fs194/en/|archive-date=10 March 2015|url-status=live}}</ref> All classes of microbes can evolve resistance
Microbes resistant to multiple antimicrobials are called [[Multiple drug resistance|multidrug resistant]] (MDR) and are sometimes referred to as '''superbugs'''.<ref name="Magiorakos">{{cite journal | vauthors = Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL | title = Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance | journal = Clinical Microbiology and Infection | volume = 18 | issue = 3 | pages = 268–281 | date = March 2012 | pmid = 21793988 | doi = 10.1111/j.1469-0691.2011.03570.x | doi-access = free }}</ref> Although antimicrobial resistance is a naturally occurring process, it is often the result of improper usage of the drugs and management of the infections.<ref name="Tanwar_2014">{{cite journal | vauthors = Tanwar J, Das S, Fatima Z, Hameed S | title = Multidrug resistance: an emerging crisis | journal = Interdisciplinary Perspectives on Infectious Diseases | volume = 2014 | pages = 541340 | date = 2014 | pmid = 25140175 | pmc = 4124702 | doi = 10.1155/2014/541340 | doi-access = free }}</ref><ref name="Saha_2021">{{cite journal | vauthors = Saha M, Sarkar A | title = Review on Multiple Facets of Drug Resistance: A Rising Challenge in the 21st Century | journal = Journal of Xenobiotics | volume = 11 | issue = 4 | pages = 197–214 | date = December 2021 | pmid = 34940513 | pmc = 8708150 | doi = 10.3390/jox11040013 | doi-access = free }}</ref> '''Antibiotic resistance''' is a major subset of AMR, that applies specifically to [[bacteria]] that become resistant to [[antibiotic]]s.<ref name="WHO2014" /> Resistance in bacteria can arise naturally by [[genetic mutation]], or by one species acquiring resistance from another.<ref>{{cite web |title=General Background: About Antibiotic Resistance |url=http://www.tufts.edu/med/apua/about_issue/about_antibioticres.shtml |url-status=dead |archive-url=https://web.archive.org/web/20151023035356/http://www.tufts.edu/med/apua/about_issue/about_antibioticres.shtml |archive-date=23 October 2015 |access-date=30 October 2015 |website=www.tufts.edu}}</ref> Resistance can appear spontaneously because of random mutations, but also arises through spreading of resistant genes through [[horizontal gene transfer]]. However, extended use of antibiotics appears to encourage selection for mutations which can render antibiotics ineffective.<ref>{{cite journal | vauthors = Dabour R, Meirson T, Samson AO | title = Global antibiotic resistance is mostly periodic | journal = Journal of Global Antimicrobial Resistance | volume = 7 | pages = 132–134 | date = December 2016 | pmid = 27788414 | doi = 10.1016/j.jgar.2016.09.003 }}</ref> '''Antifungal resistance''' is a subset of AMR, that specifically applies to fungi that have become resistant to antifungals. Resistance to antifungals can arise naturally, for example by genetic mutation or through [[aneuploidy]]. Extended use of antifungals leads to development of antifungal resistance through various mechanisms.<ref name="Fisher_2022">{{cite journal | vauthors = Fisher MC, Alastruey-Izquierdo A, Berman J, Bicanic T, Bignell EM, Bowyer P, Bromley M, Brüggemann R, Garber G, Cornely OA, Gurr SJ, Harrison TS, Kuijper E, Rhodes J, Sheppard DC, Warris A, White PL, Xu J, Zwaan B, Verweij PE | title = Tackling the emerging threat of antifungal resistance to human health | journal = Nature Reviews. Microbiology | volume = 20 | issue = 9 | pages = 557–571 | date = September 2022 | pmid = 35352028 | pmc = 8962932 | doi = 10.1038/s41579-022-00720-1 }}</ref>
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