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Antibiotikaresistenz bei bakteriellen Infektionserregern

Mikrobiologisch-epidemiologische Aspekte
  • Wolfgang Witte
  • I. Klare
Chapter

Zusammenfassung

In den vergangenen zehn Jahren traten bei bakteriellen Infektionserregern weltweit neue Resistenzeigenschaften auf (z. B.gegen Glykopeptide, Chinolone, Carbapeneme). Es kam zu einer Zunahme mehrfachresistenter Bakterienstämme. Dies betrifft zum einen Erreger von Krankenhausinfektionen (S.aureus, Enterokokken, Enterobacteriaceae, Nonfermenter) sowie auch von ambulant erworbenen Infektionen (z.B.S.pneumoniae, M.tuberculosis, S.typhimurium). Die Möglichkeit, daß neuartige Resistenzeigenschaften bei weiteren Erregergruppen auftreten und diese gegen zusätzliche antibakterielle Chemotherapeutika resistent werden (z.B. Glykopeptidresistenz bei Staphylokokken, Carbapenemase bei gram-negativen Bakterien, Resistenz gegen neue Chinolone bei S. pneumoniae), erfordert besondere Aufmerksamkeit. Die Auswirkungen der Resistenzentwicklung auf die Veränderung von Chemotherapieregimen, auf Morbidität und Behandlungskosten sind gut dokumentiert. Für begründete Aussagen hinsichtlich der Mortalität fehlen jedoch oft weiterführende Studien an vergleichbaren Patientengruppen. Für die Prävention haben ein zurückhaltender und rationaler Antibiotikaeinsatz sowie Hygienemaßnahmen, die an die jeweilige Situation angepaßt sind, eine vorrangige Bedeutung.

Antibiotic resistance in bacterial pathogens: microbiological and epidemiological aspects

Summary

During the past ten years new resistance traits have emerged in bacterial pathogens (e.g. against glycopeptides, quinolones, carbapenems), and the frequency of emergence of multiresistant isolates has increased. This is concern for nosocomial pathogens (S.aureus, enterococci, Enterobacteriaceae, nonfermenters) and also for infections in the community (e.g. S.pneumoniae, M.tuberculosis, S.typhimurium). The possibility of the emergence of new resistance characters in other groups of pathogens and against further substances (e.g. glycopeptid resistance in staphylococci, carbapenemase in gram-negative bacteria, resistance to the new fluoroquinolones in S.pneumoniae) requires special attention. The consequences of resistance development for changes of treatment regimes, for morbidity and treatment expenditures are well documented, there is however a lack of robust data with regard to mortality obtained by studies on comparable patient groups.

Priority for prevention have a rational and prudent antibiotic usage as well as situation adapted measures of infection control.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • Wolfgang Witte
    • 1
  • I. Klare
    • 1
  1. 1.Robert Koch-InstitutBereich WernigerodeWernigerodeDeutschland

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