The epidemiology of antibiotic resistance
The epidemiology of antibiotic resistance
复制标题
DOI：
10.1016/j.ijantimicag.2008.06.016
复制
发表时间：
2008-11-01
影响因子：
10.8
通讯作者：
Gould, I. M.
中科院分区：
文献类型：
--
作者：
Gould, I. M.
世界各地许多医院的抗生素耐药性已达到危机点。大多数是淹没与耐甲氧西林金黄色葡萄球菌（MRSA），许多与多药耐药（MDR）革兰氏阴性。虽然对于MRSA引起的严重感染有很好的治疗替代方案，但死亡率仍然很高。对于耐多药革兰氏阴性菌，情况更为复杂和令人担忧。在今后十年中，几乎没有任何正在开发中的新制剂可以预期对局势有利。此外，极端（或广泛）耐药甚至泛耐药革兰氏阴性菌感染越来越多地被描述。虽然在这一领域的定义是混乱的，但报告表明，一些重症监护病房的患者因缺乏任何对某些铜绿假单胞菌和鲍曼不动杆菌菌株具有活性的抗生素而死亡。如果要成功地克服耐药性，迫切需要更好地了解耐药性的分子基础。此外，我们迫切需要更好的全球预警系统，以发现新的抗药性，并建立控制抗药性的机制。(c)2008年Elsevier B.V.和国际化疗学会。All rights reserved.
Antibiotic resistance has reached crisis point in many hospitals around the world. The majority are swamped with meticillin-resistant Staphylococcus aureus (MRSA), and many with multidrug-resistant (MDR) Gram-negatives. Whilst there are good treatment alternatives available for serious infections due to MRSA, mortality rates remain high. For MDR Gram-negatives the situation is more complex and worrying. There are few, if any, new agents in development that can be expected to benefit the situation in the next decade. Moreover, extreme (or extensive) drug- resistant and even pandrug-resistant Gram-negative infections are increasingly being described. Although definitions are confused in this area, reports suggest that patients in some intensive care units are dying from lack of availability of any antibiotic active against certain strains of Pseudomonas aeruginosa and Acinetobacter baumannii. A better understanding of the molecular basis of resistance is urgently needed if it is to be successfully overcome. Moreover, we urgently need better global early warning systems to detect new resistances and put mechanisms in place for their control. (c) 2008 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.