Nosocomial antibiotic resistance in multiple gram-negative species: Experience at one hospital with squeezing the resistance balloon at multiple sites

被引:77
作者
Rahal, JJ [1 ]
Urban, C [1 ]
Segal-Maurer, S [1 ]
机构
[1] New York Hosp Queens, Infect Dis Sect, Flushing, NY 11355 USA
关键词
D O I
10.1086/338639
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Increased use of antibiotics has led to the isolation of multidrug-resistant bacteria, especially in intensive care units and long-term care facilities. Resistance in specific gram-negative bacteria, including Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, is of great concern, because a growing number of reports have documented mechanisms whereby these microorganisms have become resistant to all available antibacterial agents used in therapy. Reduction in the selection of these multidrug-resistant bacteria can be accomplished by a combination of several strategies. These include having an understanding of the genetics of both innate and acquired characteristics of bacteria; knowing resistance potentials for specific antibacterials; monitoring resistance trends in bacteria designated as problematic organisms within a particular institution on a routine basis; modifying antibiotic formularies when and where needed; creating institutional education programs; and enforcing strict infection-control practices. Strategies appropriate for primary prevention of nosocomial resistance may differ from those required for control of existing epidemic or endemic resistance.
引用
收藏
页码:499 / 503
页数:5
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