Department of Critical Care Medicine.
Department of Medical Microbiology.
Curr Opin Anaesthesiol. 2020 Apr;33(2):156-161. doi: 10.1097/ACO.0000000000000830.
Antimicrobial resistance (AMR) is increasing in ICUs around the world, but the prevalence is variable. We will review recent literature and try to answer the question whether this is a myth or a new reality, as well as discuss challenges and potential solutions.
AMR is diverse, and currently Gram-negative multidrug-resistant organisms (MDROs) are the main challenge in ICUs worldwide. Geographical variation in prevalence of MDROs is substantial, and local epidemiology should be considered to assess the current threat of AMR. ICU patients are at a high risk of infection with MDRO because often multiple risk factors are present. Solutions should focus on reducing the risk of cross-transmission in the ICU through strict infection prevention and control practices and reducing exposure to antimicrobials as the major contributor to the development of AMR.
AMR is a reality in most ICUs around the world, but the extent of the problem is clearly highly variable. Infection prevention and control as well as appropriate antimicrobial use are the cornerstones to turn the tide.
抗菌药物耐药性（AMR）在世界各地的重症监护病房（ICU）中不断增加，但流行程度存在差异。我们将回顾最近的文献，试图回答这是一个神话还是新的现实，并讨论挑战和潜在的解决方案。
AMR 具有多样性，目前革兰氏阴性多药耐药菌（MDROs）是全球 ICU 面临的主要挑战。MDRO 流行率的地理差异很大，应考虑当地的流行病学情况来评估 AMR 的当前威胁。由于 ICU 患者通常存在多种危险因素，因此他们感染 MDRO 的风险很高。解决方案应侧重于通过严格的感染预防和控制措施减少 ICU 中的交叉传播风险，并减少抗菌药物的使用，因为抗菌药物的使用是导致 AMR 发展的主要因素。
AMR 在世界上大多数 ICU 中都是一个现实，但问题的严重程度显然存在很大差异。感染预防和控制以及合理使用抗菌药物是扭转局面的基石。
