Rossolini G M, Mantengoli E
Department of Molecular Biology, Section of Microbiology, University of Siena, Siena, Italy.
Clin Microbiol Infect. 2008 Dec;14 Suppl 6:2-8. doi: 10.1111/j.1469-0691.2008.02126.x.
The problem of microbial drug resistance is a major public health concern, due to its global dimension and alarming magnitude, although the epidemiology of resistance can exhibit remarkable geographical variability and rapid temporal evolution. The major resistance issues overall are those related to methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Enterobacteriaceae producing extended-spectrum beta-lactamases, and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. Europe is not free from any of these issues, although their impact may be significantly different in different countries. MRSA rates are high in several European countries, but seem to have levelled off in some settings. Diffusion of VRE is still irregular. The most alarming resistance trends are those observed for Enterobacteriaceae and the Gram-negative non-fermenters, with a generalized increase in rates of resistance to the most important anti-Gram-negative agents (beta-lactams and fluoroquinolones) and the circulation of strains showing multidrug resistance phenotypes.
微生物耐药性问题是一个重大的公共卫生问题，因其具有全球范围且规模惊人，尽管耐药性的流行病学表现出显著的地域差异和快速的时间演变。总体而言，主要的耐药问题与耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）、产超广谱β-内酰胺酶的肠杆菌科细菌以及多重耐药的铜绿假单胞菌和鲍曼不动杆菌有关。欧洲也未能幸免这些问题，尽管其影响在不同国家可能有显著差异。在几个欧洲国家，MRSA感染率很高，但在某些情况下似乎已趋于平稳。VRE的传播仍然不均衡。最令人担忧的耐药趋势是在肠杆菌科细菌和革兰氏阴性非发酵菌中观察到的，对最重要的抗革兰氏阴性菌药物（β-内酰胺类和氟喹诺酮类）的耐药率普遍上升，以及呈现多重耐药表型的菌株的传播。
