Hemsell D L
Am J Obstet Gynecol. 1987 Feb;156(2):504-6. doi: 10.1016/0002-9378(87)90320-6.
The emergence of bacteria resistant to antibiotics has resulted in intensive research for new and improved beta-lactam antibiotics. Many improvements in antimicrobial agents are based on a knowledge of the mechanism responsible for resistance. This has led to the development of new extended-spectrum antibiotic compounds. However, several features have been noted since the development of extended-spectrum antibiotics, such as the rapid development of bacterial resistance, the induction of beta-lactamase enzyme activity by these stable antibiotics, failure to detect induced enzyme activity and resistance in the laboratory, and beta-lactam antagonism. The resistance of bacteria to antimicrobial agents has obvious impact on the selection of appropriate therapy against infections caused by these pathogens. Gram-negative anaerobic bacteria, such as Bacteroides fragilis and Bacteroides bivius, are organisms frequently recovered from women whose initial therapy for pelvic infection failed. The transfer of antimicrobial resistance in bacteria indicates that these organisms have a system for the spread of such resistance. Therefore determination of antimicrobial susceptibilities and prompt eradication of isolates from infected patients are necessary to delay the emergence of resistant organisms.
对抗生素产生耐药性的细菌的出现，引发了对新型和改良型β-内酰胺抗生素的深入研究。抗菌剂的许多改进都基于对耐药机制的了解。这导致了新型广谱抗生素化合物的开发。然而，自从广谱抗生素开发以来，已经注意到几个特征，例如细菌耐药性的快速发展、这些稳定抗生素诱导β-内酰胺酶活性、在实验室中未能检测到诱导酶活性和耐药性以及β-内酰胺拮抗作用。细菌对抗菌剂的耐药性对选择针对由这些病原体引起的感染的适当治疗方法有明显影响。革兰氏阴性厌氧菌，如脆弱拟杆菌和双路拟杆菌，是从盆腔感染初始治疗失败的女性中经常分离出的微生物。细菌中抗菌耐药性的转移表明这些生物体具有这种耐药性传播的系统。因此，确定抗菌药敏性并迅速清除感染患者的分离株对于延缓耐药生物体的出现是必要的。
