Monitoring of resistant organisms in man and identification of their origin

Abstract

Information on the epidemiology of bacterial resistance is fragmentary despite an enormous number of publications since the introduction of antibiotics to human medicine, and remains a field of speculation mixed and influenced by fear of the total collapse of antimicrobial chemotherapy by development of resistance (for review see Wiedermann et al., 1986). Bacteria have evolved mechanisms to withstand the attack of antibiotics and, in parallel, mechanisms for the spread of these characters to other bacteria by means of exchange of genetic information. However the development of resistance cannot be generalized. Staphylococcus aureus gained penicillin resistance within a few years after the introduction of this drug, while Streptococcus pyogenes remains 100% susceptible to penicillin, despite of the long use of penicillins in huge quantities. Thus any statement about the development and epidemiology of resistance has to be addressed specifically to a drug, a bacterial species, and a location. Until now there is no identifiable general trend, which would allow us to deduce a general picture or a future development from a limited database. In this paper long term multicentre studies are presented to demonstrate the area of concern for the treatment of human infections. In this context it is of specific interest to try and trace the origin of bacteria which cause infections in humans.