MICROBIAL RESISTANCE TO ANTIBIOTICS

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Abstract
An estimate is made of the extent of the problem of antibiotic-resistant organisms as a cause of bacterial infections. The importance of host factors in allowing resistant infections to become established and to persist is emphasized. Infections with Mvcobacterium tuberculosis, enterococci and some related relatively resistant non-group-A streptococci, Proteus and Pseudomonas infections, other Gram-negative rods in the Escherichia coli, Aerobacter. paracolon and intermediate group and Micrococcus pyogenes var. aureus infections, are the principal groups of bacteria which at the present time present a clinical problem. Each of these infections has its own peculiarities as far as the relative importance of the host, site of the infection, importance of different antibiotics and environment in which the patient has been studied is concerned. Contrast is made, between the development of resistance of M. tuberculosis in which the resistant clone which multiplies under the influence of the antibiotic is most important and in which spread from one individual to another is relatively unimportant, with M. p. var. aureus where the development of resistant strains in a patient were not of as much significance as the dissemination of resistant strains between personnel and patients. Methods of minimizing difficulties from antibiotic-resistant infection includes use of combinations of drugs, use of minimal effective doses of limited spectrum drugs selected in patients with chronic disease after careful bacteriologic study, remedy of underlying defects, and nursing precautions to avoid spread of resistant bacteria.
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