CURRENT PERSPECTIVES ON MULTIDRUG-RESISTANT BACTERIA : Epidemiology and Control - 11/09/11
Résumé |
As you have sown, so shall ye reap.
CICERO (106–43 BC)
The introduction of antibacterial drug therapy in the 1940s led to a dramatic reduction in illness and death from infectious diseases over the next 50 years. The emergence of drug-resistant bacteria, mycobacteria, fungi, and viruses, however, is reversing the trend.102 Bacterial resistance has evolved in both institutional and community settings.100, 11 Factors responsible for the emergence of resistant organisms are as follows:
• | Selection of antibiotic resistance genes among virtually all bacterial pathogens |
• | Increase in high-risk (immunodeficient) human populations |
• | Prolonged survival of individuals with chronic debilitating diseases that eventually require prolonged hospitalizations and antibiotic courses |
• | Congregate facilities as reservoirs for multiresistant bacteria (hospitals, long-term care facilities, correctional institutions, child day-care centers) |
• | Lack of rapid, accurate diagnostic tests to distinguish between viral and bacterial infection, leading to excess antibiotic use |
• | Public pressure on physicians for treatment of minor illnesses |
• | Decreased public funding for national and local epidemiologic surveillance |
• | Increased use of antibiotics in animal husbandry and agriculture |
This article confines its attention to multiply-resistant bacteria and mycobacteria. Emphasis is placed on epidemiology, mechanisms of resistance, diagnosis, and prevention, now crucial as the number of effective therapeutic options dwindle away.
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| Address reprint requests to Sorana Segal-Maurer, MD, The New York Hospital Medical Center of Queens, 56-45 Main Street, Flushing, NY 11355 |
Vol 10 - N° 4
P. 939-957 - décembre 1996 Retour au numéro
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- PERSPECTIVES IN FATAL EPIDEMICS
- Jay C. Butler, Peter H. Kilmarx, Daniel B. Jernigan, Stephen M. Ostroff
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