The impact of antimicrobial use on the emergence of antimicrobial-resistant bacteria in hospitals
The impact of antimicrobial use on the emergence of antimicrobial-resistant bacteria in hospitals
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DOI：
10.1016/s0891-5520(05)70388-3
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发表时间：
1997-12-01
影响因子：
4.4
通讯作者：
Gaynes, R
中科院分区：
文献类型：
--
作者：
Gaynes, R
大量证据表明，抗菌素耐药性与使用之间存在联系，包括动物模型、耐药性与医院抗菌药物使用之间的一致关联、随着抗菌剂使用的不同而伴随的耐药性变化，以及许多病原体/抗菌药物组合的剂量-反应关系。大部分证据来自于在单一医院进行的研究。大多数关于耐药性的多中心研究都没有包括抗菌药使用的数据。尽管有大量证据，但一些研究尚未证明抗菌素耐药性与使用之间的联系，这表明其他促成因素，如交叉传播、耐药性的医院间转移、社区对耐药性的贡献，或耐药性与各种抗菌剂的使用之间的复杂关系。如果不了解医院的抗菌药使用模式，就不可能了解医院的抗菌素耐药性问题。
Abundant evidence suggests a relationship between antimicrobial resistance and use, including animal models, consistent associations between resistance and antimicrobial use in hospitals, concomitant variation in resistance as antimicrobial use varies, and a dose-response relationship for many pathogen/antimicrobial combinations. Much of the evidence is from studies performed in single hospitals. Most multicenter studies on resistance have not included data on antimicrobial usage. Despite this substantial body of evidence, some studies have not demonstrated an association between antimicrobial resistance and use, suggesting other contributing factors such as cross transmission, interhospital transfer of resistance, a community contribution to resistance, or a complex relationship between resistance and the use of a variety of antimicrobials. Understanding the problem of antimicrobial resistance in a hospital cannot be achieved without knowledge of the hospital's pattern of antimicrobial use.