Cohen F L, Tartasky D
School of Nursing, Southern Illinois University at Edwardsville 62026-1066, USA.
Am J Infect Control. 1997 Feb;25(1):51-64. doi: 10.1016/s0196-6553(97)90054-7.
Microbial resistance to the antimicrobials in standard use is becoming more prevalent. A historical perspective frames further discussion. Bacterial resistance is most common, but resistance has been identified in fungi, viruses, and parasites. Resistance is a complex phenomenon that involves the microorganism, the environment, and the patient-separately and interactively. Resistance may be a characteristic of the microbe before exposure to a given drug or may arise as a consequence of therapy. Mechanisms of resistance to antibiotics are discussed. Antibiotic resistance is considered in both hospital and community settings, as ecosystems that are separate yet blending, and the major organisms demonstrating significant resistance problems are presented. A review of existing guidelines, strategies, and plans for addressing resistance and some recommendations conclude this review.
微生物对常用抗菌药物的耐药性正变得越来越普遍。从历史角度进行阐述有助于进一步讨论。细菌耐药最为常见，但在真菌、病毒和寄生虫中也已发现耐药现象。耐药是一种复杂的现象，分别及相互涉及微生物、环境和患者。耐药可能是微生物在接触特定药物之前就具有的特性，也可能是治疗的结果。文中讨论了抗生素耐药机制。在医院和社区环境中都考虑了抗生素耐药问题，这两种环境虽相互独立但又相互交融，文中还介绍了显示出重大耐药问题的主要微生物。回顾了现有的应对耐药性的指南、策略和计划，并给出了一些建议作为本次综述的结论。
