Masterton R G
Department of Clinical Microbiology, Western General Hospital, Edinburgh, UK.
J Antimicrob Chemother. 2000 Sep;46 Suppl T2:53-8.
The increase in antimicrobial resistance has led to predictions of doom in the international press and to depression in the medical community. It has focused attention upon measures for fighting resistance, foremost of which is susceptibility surveillance. Until recently, global efforts at surveillance have been largely uncoordinated and random. This scene is rapidly changing with the World Health Organization (WHO), among others, leading multidisciplinary, targeted initiatives. In terms of individual surveillance programmes, much has been learned about their design. The best of these, the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC), SENTRY and the Alexander Project, involve well-defined patient and organism groups against key denominators, and use standardized, internationally recognized methods that are quality-controlled, explore susceptibility quantitatively and include investigation of resistance mechanisms. Results are rapidly returned to the user. Evidence shows that surveillance, when used to guide policies on antibiotic use and infection control, can be helpful in the fight to control the development and spread of resistance. Further work is required to demonstrate these benefits and quantify them fully.
抗菌药物耐药性的增加在国际媒体上引发了末日预言，并使医学界感到沮丧。它将人们的注意力集中在对抗耐药性的措施上，其中最重要的是药敏监测。直到最近，全球范围内的监测工作在很大程度上一直缺乏协调且随意。随着世界卫生组织（WHO）等机构牵头开展多学科、有针对性的举措，这种情况正在迅速改变。就个别监测项目而言，人们对其设计已有很多了解。其中最出色的项目，如美罗培南年度药敏试验信息收集（MYSTIC）、哨兵项目和亚历山大项目，涉及针对关键分母的明确患者和生物体群体，并使用经过质量控制的标准化国际认可方法，定量探索药敏情况并包括对耐药机制的研究。结果会迅速反馈给用户。有证据表明，当监测用于指导抗生素使用和感染控制政策时，有助于控制耐药性的发展和传播。还需要进一步开展工作来证明这些益处并对其进行充分量化。
