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Antimicrobial Drug Use and Antibiotic-Resistant Bacteria

机译:抗菌药物的使用和抗细菌细菌

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To the Editor: The article by Har-ris et al., published in the August 2007 issue of Emerging Infectious Diseases, examined the risk factors for selecting extended-spectrum β-lactamase–pro-ducing Enterobacteriaceae in inten-sive-care patients and found that ex-posure to piperacillin/tazobactam and vancomycin were independent risk factors (1). Although antimicrobial drug use has been historically linked to antibiotic resistance in bacteria, we should not miss the perspective that such a risk factor mostly favors the cross-transmission of preexisting an-tibiotic-resistant bacteria, taking into account the disruption of the endog-enous micro. ora, rather than the se-lection of "de novo" resistant mutants (2). This supposition is supported by many articles that have found genetic similarity between antibiotic-resistant microorganisms that occur in hospi-talized patients, as well as by the fact that most of these pathogens exhibit cross-resistance with different classes of drugs, which should be extremely rare on a mutation basis
机译:致编辑:Har-ris等人的文章(发表于2007年8月的《新兴传染病》)探讨了在重症监护患者中选择广谱β-内酰胺酶生产肠杆菌科细菌的危险因素,以及发现暴露于哌拉西林/他唑巴坦和万古霉素是独立的危险因素(1)。尽管抗菌药物的使用一直与细菌对抗生素的耐药性有关,但考虑到内源性细菌的破坏,我们不应该错过这样一种风险因素,即该风险因素主要有利于先前存在的抗抗生素细菌的交叉传播。微。 ora,而不是选择“从头”抗性突变体(2)。许多研究发现在住院患者中出现的抗生素抗性微生物之间具有遗传相似性,而且大多数这些病原体与不同种类的药物表现出交叉耐药性,这一观点得到了很多支持。很少发生突变

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