Bonomo R A
Geriatric Care Center, University Hospitals of Cleveland, OH, USA.
Clin Infect Dis. 2000 Dec;31(6):1414-22. doi: 10.1086/317489. Epub 2000 Nov 29.
Long-term-care facilities (LTCFs) are becoming a major component of the health care delivery system. The management of infections with antibiotic-resistant bacteria in elderly patients in LTCFs is presenting new challenges to our current therapeutic armamentarium. Among the enteric bacilli, resistance to ceftazidime, beta-lactam/beta-lactamase-inhibitor combinations, and trimethoprim-sulfamethoxazole present the foremost problems. Quinolone-resistant gram-negative and gram-positive bacteria are increasing in frequency because of the widespread use of these agents in empirical treatment. Among the resistant gram-positive organisms, methicillin-resistant Staphylococcus aureus, penicillin-resistant pneumococci, and vancomycin-resistant enterococci are the most feared pathogens. Education, antibiotic control measures, and fundamental epidemiological and scientific research are advocated as important preventive measures.
长期护理机构（LTCFs）正成为医疗保健服务体系的一个主要组成部分。长期护理机构中老年患者的耐抗生素细菌感染管理给我们当前的治疗手段带来了新的挑战。在肠道杆菌中，对头孢他啶、β-内酰胺/β-内酰胺酶抑制剂组合以及甲氧苄啶-磺胺甲恶唑的耐药性是最主要的问题。由于喹诺酮类药物在经验性治疗中的广泛使用，耐喹诺酮的革兰氏阴性和革兰氏阳性细菌的出现频率正在增加。在耐药革兰氏阳性菌中，耐甲氧西林金黄色葡萄球菌、耐青霉素肺炎球菌和耐万古霉素肠球菌是最令人担忧的病原体。倡导开展教育、采取抗生素控制措施以及进行基础流行病学和科学研究，将其作为重要的预防措施。
