Development of Antibiotic Resistance during Conventional and SDD
There is little doubt that resistance to antimicrobial agents does develop following therapy with such agents. In intensive care units (ICUs), where a large proportion of the patients are likely to be receiving antibiotics, the likelihood of such an event is greatly increased. Epidemic and endemic spread of infection and/or colonization with a variety of microorganisms resistant to the latest antibiotic have been described both in adult [1, 2, 3] and in neonatal [4, 5] ICUs. In many instances such resistance is plasmid-encoded (see Dr Shears’ chapter), so that resistance may spread to other types of bacteria. In addition, plasmids may encode resistance to many different antimicrobials, and the use of one antibiotic might select for resistance to several others. In this respect it is noteworthy that treatment with ampicillin or cotrimoxazole was shown to be more important in selecting for gentamicin- and multiply-resistant klebsiellae than gentamicin itself . It is clear that development of new antimicrobials is only just keeping ahead of development of resistance.
KeywordsNeonatal Intensive Care Unit Acinetobacter Species Selective Decontamination Patient Develop Wound Infection Lactamase Enzyme
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