Microbiological aspects of ozone: bactericidal activity and antibiotic/antimicrobial resistance in bacterial strains treated with ozone

Antimicrobial resistance is one of the most complex global health challenges today. The world has long ignored warnings that antibiotics and other medicines are losing their effectiveness after decades of overuse and misuse in human medicine, animal health and agriculture. Common illnesses like pneumonia, postoperative infections, diarrhoeal and sexually transmitted diseases, as well as the world’s largest infectious disease killers – tuberculosis (TB), HIV and malaria – are increasingly becoming untreatable because of the emergence and spread of drug resistance. Worsening antimicrobial resistance could have serious public health, economic and social implications. The threat of antimicrobial resistance is also becoming a key consideration for programmes addressing maternal and child health, sexual and reproductive health, foodborne diseases, water and sanitation, and infection prevention and control. Although the 21st century is being shaped by technology and innovation, humans could soon find themselves in an era where simple infections once again kill millions every year. The past three years have seen unprecedented global political momentum to address antimicrobial resistance: in 2015, governments adopted a global action plan at the World Health Assembly and in 2016 passed a political declaration at the United Nations General Assembly. Antimicrobial resistance has made it onto the agendas of the G7 and G20 groups and is a core component of the Global Health Security Agenda. WHO is working closely with the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health in leading global efforts against antimicrobial resistance and ensuring that the necessary momentum is consolidated and sustained. These efforts are guided by an ad-hoc interagency coordination group established in 2017. A global development and stewardship framework to combat antimicrobial resistance is being drafted to support the development of new antimicrobial medicines, diagnostics, vaccines and other tools. One of the gravest global concerns about antimicrobial resistance currently is that antibiotic resistance has emerged in so many pathogens, including TB. In 2016, at the high-level meeting of the UN General Assembly on antimicrobial resistance, Heads of State directed an unprecedented level of attention to curbing the spread of infections that are resistant to antimicrobial medicines. They reaffirmed their commitment to stopping the misuse of antimicrobial medicines in human health, animal health and agriculture, and recognized the need for stronger systems to monitor drug-resistant infections and the amounts of antimicrobials used in humans and animals. In the wake of the increasing global awareness of the need for new antibiotics, Member States highlighted market failures, and called for new incentives for investment in research and development of new, effective and affordable medicines, rapid diagnostic tests, and other important therapies to replace those that are losing their effectiveness. In response to this and in line with the Global Action Plan on Antimicrobial Resistance to support the identification of pathogens of greatest concern, WHO developed a priority list of antibiotic resistant bacteria to underpin renewed efforts for the research and development of new antibiotics. The only possible defence against the threat of antimicrobial resistance and the (very real) possibility of a post-antibiotic era is a global and coordinated effort by all stakeholders to support other important therapies such as the Oxygen-Ozone (O₂O₃) therapy. As a result, the scope and focus of the work underlying this dissertation was to study the application of O₂O₃ therapy towards several resistant bacteria. Moreover, we evaluated three different framework for gut bacteria, skin and soft tissue infections and mucosal infections.