Why do antimicrobial agents become ineffectual?.
10.3349/ymj.1998.39.6.502
- Author:
Matsuhisa INOUE
1
;
Akio KUGA
;
Chieko SHIMAUCHI
;
Hisakazu YANO
;
Ryouichi OKAMOTO
Author Information
1. Department of Microbiology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara City, Kanagawa-ken, 228- 8555, Japan. matsu @kitasato-u.ac.jp
- Publication Type:Review ; Research Support, Non-U.S. Gov't
- Keywords:
Emergence of resistance;
nosocomial spread;
Cmax/MIC80;
MRSA;
coagulase type;
PFGE patterns
- MeSH:
Cross Infection/physiopathology;
Drug Resistance, Microbial/physiology*;
Enzymes/physiology;
Methicillin Resistance/physiology;
Staphylococcus aureus/physiology
- From:Yonsei Medical Journal
1998;39(6):502-513
- CountryRepublic of Korea
- Language:English
-
Abstract:
Antibiotic resistance has evolved over the past 50 years from a merely microbiological curiosity to a serious medical problem in hospitals all over the world. Resistance has been reported in almost all species of gram-positive and -negative bacteria to various classes of antibiotics including recently developed ones. Bacteria acquire resistance by reducing permeability and intracellular accumulation, by alteration of targets of antibiotic action, and by enzymatic modification of antibiotics. Inappropriate use of an antibiotic selects resistant strains much more frequently. Once resistant bacteria has emerged, the resistance can be transferred to other bacteria by various mechanisms, resulting in multiresistant strains. MRSA is one of the typical multiresistant nosocomial pathogens. A study of the PFGE pattern of endonuclease-digested chromosomal DNA showed that MRSA of a few clones were disseminated among newborns in the NICU of a Japanese hospital. In this regard, it is important to choose appropriate antibiotics and then after some time, to change to other classes to reduce the selection of resistant strains. Since the development of epoch-making new antibiotics is not expected in the near future, it has become very important to use existing antibiotics prudently based on mechanisms of antibiotic action and bacterial resistance. Control of nosocomial infection is also very important to reduce further spread of resistant bacteria.
