Dissemination of antibiotic-resistant bacteria across geographic borders

The development of antibiotic-resistant (AR) bacteria in any country is of global importance. After their initial selection and local dissemination, A R bacteria can be transferred across international borders by human travele rs, animal and insect vectors, agricultural products, and surface water. Th e sources and routes of importation of strains of AR bacteria are most ofte n unknown or undetected, because many bacteria carrying resistance genes do not cause disease, and routine surveillance often does not detect them. Co ntrol of international dissemination of AR bacteria depends on methods to r educe selection pressure for the development of such bacteria and improved surveillance to detect their subsequent spread.