Division of Infectious Diseases, UMDNJ-Robert Wood Johnson Medical School, Cooper University Hospital, 401 Haddon Avenue, Room 274, Camden, NJ 08103, USA.
Crit Care Clin. 2011 Jan;27(1):163-205. doi: 10.1016/j.ccc.2010.11.002.
Infections caused by drug-resistant and multidrug-resistant microbial pathogens pose tremendous challenges to health care systems, including challenges related to the diagnosis, treatment, and containment of these infections. These challenges are amplified in the intensive care unit (ICU), where pressures for selection and emergence of resistance and risks of transmission of resistant pathogens are highest, and where the threat of resistance drives selection of empiric antimicrobial regimens. This article reviews basic concepts of resistance to antibacterial agents including mechanisms and modes of transmission, and discusses management issues for the important drug-resistant pathogens found in the ICU.
耐药和多药耐药微生物病原体引起的感染对医疗保健系统构成了巨大挑战，包括与这些感染的诊断、治疗和控制相关的挑战。这些挑战在重症监护病房（ICU）中更为严重，因为在 ICU 中，耐药和传播风险的选择和出现压力最高，而耐药性的威胁导致经验性抗菌治疗方案的选择。本文回顾了抗菌药物耐药的基本概念，包括耐药机制和传播方式，并讨论了 ICU 中发现的重要耐药病原体的管理问题。
