12 Chapter 1 Antibiotic resistance, what is it and why is it a global problem? Infectious diseases have plagued humanity since ancient times, presenting a significant challenge. For centuries, little was understood about their causes, let alone finding cures. Among the microorganisms responsible for these diseases, bacteria have played a crucial role in mortality and morbidity. From the devastating plagues of Yersinia pestis in the Middle Ages to the widespread cholera outbreaks in the 19th century, bacterial infections have been a leading cause of death and despair throughout history (Glatter and Finkelman 2021; Waldman, Ronald and Claeson, Mariam 2023). A pivotal moment in the fight against infectious diseases occurred in the 19th century with the discovery that bacteria were the root cause of many common infections. This breakthrough was made possible by the pioneering work of Robert Hermann Koch, one of the foremost scientists in the field of microbiology (Münch 2003). Using Koch’s postulates, which provided a framework for establishing the pathogenicity of bacteria, scientists were able to confirm their role as disease-causing agents. This understanding laid the foundation for the development of antimicrobial therapeutics to combat infectious diseases. The first breakthrough in this regard came in 1910 with the discovery of arsphenamine, also known as salvarsan, as a cure for syphilis (Hutchings, Truman, and Wilkinson 2019; Christensen 2021). Shortly thereafter, the antibiotic effect of sulphonamides was uncovered, leading to their widespread use as antibiotics. One of the most well-known discoveries in the field was made by Alexander Fleming in 1928 when he observed the inhibitory effect of penicillin, produced by the fungus Penicillium chrysogenum, on the growth of Staphylococcus aureus bacteria he was studying (Lobanovska and Pilla 2017). Although the antimicrobial properties of many soil microorganisms, such as actinomycetales, were known before Fleming’s discovery, the identification, purification, and stabilization of penicillin marked a monumental scientific breakthrough in the medical and pharmaceutical realms (Clardy, Fischbach, and Currie 2009). Many widely used antibiotics, including cephalosporins and carbapenems, belong to the same class as penicillin—beta-lactams. These beta-lactam antibiotics play a crucial role in the treatment of bacterial infections. For instance, in the Netherlands, cephalosporins and carbapenems are the preferred antimicrobial agents for septicaemia (Sieswerda et al. 2020). The discovery of penicillin, a significant antibiotic, has been accompanied by a drawback—the emergence of antibiotic resistance (Lobanovska and Pilla 2017; Zaman
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