Livermore David M
Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK.
Ann Med. 2003;35(4):226-34. doi: 10.1080/07853890310001609.
In terms of numbers of isolates, the greatest present resistance problems arise with gram-positive pathogens (which stain purple/black in Gram's method), especially methicillin-resistant Staphylococcus aureus (MRSA). But, is the MRSA problem--by its size--blinding us to something ultimately more dangerous: the slow emergence of gram-negative pathogens (which stain pink) with resistance to all reliable antibiotics? Although presently rare, 'pan-resistant' gram-negative bacteria--predominantly strains of Pseudomonas aeruginosa and Acinetobacter baumannii--have more comprehensive resistance than any gram-positive pathogen. They already pose treatment problems in compromised hospital patients, especially in specialist units, as well in particular groups, such as cystic fibrosis patents. Disturbingly, there is a near-total lack of developmental antibiotics active against gram-negative pathogens.
就分离菌株的数量而言，目前最大的耐药性问题出现在革兰氏阳性病原体（在革兰氏染色法中染成紫色/黑色）上，尤其是耐甲氧西林金黄色葡萄球菌（MRSA）。但是，MRSA问题因其规模是否使我们忽视了最终更危险的东西：对所有可靠抗生素都具有耐药性的革兰氏阴性病原体（染成粉红色）的缓慢出现？尽管目前很少见，但“泛耐药”革兰氏阴性菌——主要是铜绿假单胞菌和鲍曼不动杆菌菌株——比任何革兰氏阳性病原体都具有更广泛的耐药性。它们已经给医院中病情复杂的患者带来了治疗难题，尤其是在专科病房，以及特定群体中，如囊性纤维化患者。令人不安的是，几乎完全缺乏对革兰氏阴性病原体有效的新型抗生素。
