Kaushik Dwarikadhish, Mohan Mudit, Borade Dhammraj M, Swami Onkar C
Consultant Physician, Department of Critical Care Medicine, St Joseph Hospital , Mariyam Nagar, Nandgram Ghaziabad-201003, UP, India .
Consultant Physician, Department of Medicine, Yashoda Hospital , Ghaziabad, UP, India .
J Clin Diagn Res. 2014 May;8(5):ME01-3. doi: 10.7860/JCDR/2014/8777.4356. Epub 2014 May 15.
Antimicrobial resistance (AMR) is a global problem. AMR has posed new challenges in treatment of infectious diseases. Antimicrobials are losing efficacy due to development of resistant pathogens. It has lead to re-emergence of certain infectious diseases. Treatment of such diseases has undergone changes with use of alternative antimicrobials and drug combinations. Pathogens are likely to develop resistance to alternative antimicrobials also and risk of infections with nonexistent treatment is real. Salmonella showed widespread resistant to ampicillin which resulted in use of alternative antimicrobials like fluroquinolones and cephalosporins in the treatment of enteric fever in last two decades. Unfortunately there are growing reports of resistance to these antimicrobials. Interestingly there are numerous reports of ampicillin regaining activity against Salmonella. Speculatively lack of exposure of Salmonella to ampicillin for long time resulted in the loss of plasmid mediated resistance in the pathogen. There may have been emergence of de novo ampicillin susceptible strains. This is assuring in the era where problem of AMR is compounded by the scarcity of new antimicrobial development.
抗菌药物耐药性（AMR）是一个全球性问题。AMR在传染病治疗方面带来了新的挑战。由于耐药病原体的出现，抗菌药物正在失去效力。这导致某些传染病再次出现。随着替代抗菌药物和药物组合的使用，此类疾病的治疗方法发生了变化。病原体也可能对替代抗菌药物产生耐药性，并且存在无药可治的感染风险。沙门氏菌对氨苄西林表现出广泛耐药，这导致在过去二十年中，氟喹诺酮类和头孢菌素类等替代抗菌药物被用于治疗伤寒热。不幸的是，对这些抗菌药物耐药的报道越来越多。有趣的是，有许多关于氨苄西林恢复对沙门氏菌活性的报道。据推测，沙门氏菌长时间未接触氨苄西林导致该病原体失去了质粒介导的耐药性。可能出现了新的对氨苄西林敏感的菌株。在AMR问题因新抗菌药物研发稀缺而更加复杂的时代，这是令人欣慰的。
