Antimicrobial Resistance

Description

Preventing, controlling and treating drug-resistant infections is one of the major challenges in modern medicine. Antimicrobial Resistance goes beyond simple definitions and microbiological data to fully explore this rapidly changing area, describing evidence for effective interventions, costs, treatment strategies and directions for future research.Each chapter provides essential background and examines the evidence for an important aspect of prevention and control, treatment strategy or policy decision. Prevention and control strategies are analyzed for inappropriate antimicrobial use, fluoroquinolone-resistant organisms, health-care associated infections and parasitic diseases. Furthermore, treatment strategies for changing resistance patterns are explored for community-acquired pneumonia during an influenza pandemic and infections with community-associated MRSA, extended-spectrum beta-lactamase producing organisms and fungi. Data for policy making are presented in articles that detail the costs of antimicrobial-resistant infections in healthcare settings and the threat of resistance with the introduction of antiretroviral therapy for large populations in the developing world. These reviews show where interventions, surveillance and research will be most useful in the future. Antimicrobial Resistance is an invaluable contribution for infectious disease physicians and public health officials who are interested in the prevention of antimicrobial-resistant infections.

Informations

• Publié par: S. Karger AG
• Date de parution: 17 mars 2010
• Nombre de lectures: 0
• EAN13: 9783805593243
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Antimicrobial Resistance – Beyond the Breakpoint
Issues in Infectious Diseases
Vol. 6
Series Editor
Brian W.J. Mahy    Atlanta, Ga.
 
Antimicrobial Resistance
Beyond the Breakpoint
Volume Editor
J. Todd Weber Stockholm
4 figures and 18 tables, 2010
Issues in Infectious Diseases
_________________________
J. Todd Weber U.S. Centers for Disease Control and Prevention c/o European Centre for Disease Prevention and Control 171 83 Stockholm (Sweden)
Library of Congress Cataloging-in-Publication Data
Antimicrobial resistance: beyond the breakpoint/volume editor, J.Todd Weber.
p.; cm. -- (Issues in infectious diseases, ISSN 1660-1890; v. 6)
Includes bibliographical references and index.
ISBN 978-3-8055-9323-6 (hard cover: alk. paper)
1. Drug resistance in microorganisms. I. Weber, J.Todd. II. Series: Issues in infectious diseases, v. 6.1660-1890;
[DNLM:1. Drug Resistance, Microbial. QW 45 A6306 2010]
QR177.A5855 2010
616.9'041-dc22
2009049841
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and Index Medicus
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2010 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel
ISSN 1660-1890
ISBN 978-3-8055-9323-6
e-ISBN 978-3-8055-9324-3
 
Contents
Foreword
Mahy, B.W.J. (Atlanta, Ga.)
Preface
Weber, J.T. (Stockholm)
Community-Associated Methicillin Resistant Staphylococcus aureus
Miller, L.G. (Torrance, Calif.)
Infections with Organisms Producing Extended-Spectrum ß-Lactamase
Paterson, D.L.; Doi, Y. (Pittsburgh, Pa.)
Fluoroquinolone Resistance: Challenges for Disease Control
Parry, C.M. (Liverpool)
Antibiotic Resistance and Community-Acquired Pneumonia during an Influenza Pandemic
Moore, M.R.; Whitney, C.G. (Atlanta, Ga.)
Promoting Appropriate Antimicrobial Drug Use in the Outpatient Setting: What Works?
Belongia, E.A. (Marshfield, Wisc.); Mangione-Smith, R. (Seattle, Wash.); Knobloch, M.J. (Marshfield, Wisc.)
Reducing Antimicrobial-Resistant Infections in Health Care Settings: What Works?
Rezai, K.; Weinstein, R.A. (Chicago, Ill.)
Cost of Antimicrobial Resistance in Healthcare Settings: A Critical Review
Merz, L.R.; Guth, R.M.; Fraser, V.J. (St. Louis, Mo.)
Mass Treatment of Parasitic Disease: Implications for the Development and Spread of Anthelmintic Resistance
Churcher, T.S. (London); Kaplan, R.M. (Athens, Ga.); Ardelli, B.F. (Brandon); Schwenkenbecher, J.M. (Aberdeen); Basáñez, M.-G. (London); Lammie, P.J. (Atlanta, Ga.)
Antifungal Drug Resistance: Clinical Importance, in vitro Detection and Implications for Prophylaxis and Treatment
Arthington-Skaggs, B.A (Maputo); Frade, J.P. (Atlanta, Ga.)
Preparing for HIV Drug Resistance in the Developing World
Bennett, D.E. (Atlanta, Ga.)
Author Index
Subject Index
 
Foreword
This volume in the series Issues in Infectious Diseases deals with one of the most important topics in the field: antimicrobial resistance.
Since antimicrobial drugs were first discovered and used during the Second World War, they have saved countless lives and eased the suffering of millions of people. Unfortunately, in recent years we have seen the emergence and spread of microbes that have acquired resistance to many of the antibiotics in widespread use. Some of the most important of these are penicillin-resistant Streptococcus pneumoniae , vancomycin-resistant enterococci, multidrug-resistant salmonellae and Mycobacterium tuberculosis , and methicillin-resistant Staphylococcus aureus (commonly known as MRSA).
The consequences of infection with these widespread antibiotic-resistant microbes have led to patients fearing to enter hospitals, since medical facilities are often sources of such microbes.
In this, the sixth volume of this series, we consider the full scale of the costs of antimicrobial resistance to our society, both in human and economic terms.
Brian W.J. Mahy
Centers for Disease Control and Prevention, Atlanta, Ga.
 
Preface
One characteristic which streptomycin seems unfortunately to share with many antibiotics is that of rapidly inducing in susceptible organisms a high resistance to the drug. This is a subject which obviously offers interesting prospects for analysis.
Sir Howard W. Florey Penicillin Nobel Lecture, December 11, 1945
Florey was instrumental in launching the antibiotic era and his observations are as true now as they were then. In 2009, the Royal Swedish Academy of Sciences awarded the Nobel Prize in Chemistry to Venkatraman Ramakrishnan, Thomas A. Steitz and Ada E. Yonath ‘for studies of the structure and function of the ribosome’. Their work included the creation of three-dimensional models used by scientists to develop new antibiotics, which the Royal Academy said had directly assisted in saving lives and decreasing humanity's suffering. However, we can anticipate that microbes will develop resistance to any new antimicrobial drugs developed on the basis of this or another scientific discovery, eventually making the drugs powerless against one, many or all infections.
At the most simple and definitional level, resistance is the numerical value generated by susceptibility testing to determine whether a microorganism meets criteria for being ‘susceptible’, ‘intermediate’ or ‘resistant’ to an antimicrobial drug. These terms are colloquially referred to as ‘breakpoints’. But the real measure of impact is the ability to cure infections and improve the health of patients. Antimicrobial (or, synonymously, antibiotic) resistance has cut a swath through the effectiveness of all antimicrobial classes used to treat infectious diseases. Listing the combinations of drugs and their counterpart resistant pathogens would be a volume in itself. However, for bacteria important examples include the aminoglycosides (resistance in Acinetobacter baumannii and Pseudomonas aeruginosa causing infections in critically ill patients), aminopenicillins (resistance in community-acquired infections and Enterococcus spp. that cause bloodstream infections in hospitalized patients), carbapenems (resistance in Klebsiella pneumoniae that causes healthcare-associated infections), quinolones (resistance in various Gram-negative and Gram-positive bacteria such as Escherichia coli causing urinary tract infections and Neisseria gonorrhoeae causing sexual transmitted infections), cephalosporins (resistance in various Gram-negative and Gram-positive bacteria associated with community- and healthcare-associated infections), antipseudomonal cephalosporins (resistance in Pseudomonas aeruginosa ), macrolides (resistance in pneumonia and meningitis caused by Streptococcus pneumoniae ), and anti-staphylococcal semi-synthetic penicillins (resistance in Staphylococcus aureus causing community-associated and healthcare-associated skin and soft-tissue infections including surgical-site infections).
In addition, there is ubiquitous antimalarial resistance that has hampered malaria treatment and prophylaxis worldwide, anti-tuberculous drug resistance that has forced longer and more toxic regimens against tuberculosis, antiretroviral resistance in HIV requiring increasingly complex regimens, and antiviral resistance among seasonal influenza strains further reducing already limited treatment options. If we are willing to include the visible among the category of'microbes’, increasing resistance of lice ( Pediculus humanus capitis ) to treatment should also be noted.
This volume does not address the very important problem of the paucity of new antimicrobial drugs and drug classes in the pharmaceutical pipeline. If this pipeline had been full and flowing in recent years, there would be less concern over resistance to older drugs. Instead, there have been few new antimicrobial drugs developed, even fewer new classes, and several large pharmaceutical companies have abandoned research and develo