: J.T. Weber
: Antimicrobial Resistance Beyond the Breakpoint.
: Karger
: 9783805593243
: 1
: CHF 203.80
:
: Gesundheit
: English
: 184
: DRM
: PC/MAC/eReader/Tablet
: PDF/ePUB
Preventing, controlling and treating drug-resistant infections is one of the major challenges in modern medicine. Antimicrobial Resistance goes beyond simple definitions and microbiological data to fully explore this rapidly changing area, describing evidence for effective interventions, costs, treatment strategies and directions for future research.Each chapter provides essential background and examines the evidence for an important aspect of prevention and control, treatment strategy or policy decision. Prevention and control strategies are analyzed for inappropriate antimicrobial use, fluoroquinolone-resistant organisms, health-care associated infections and parasitic diseases. Furthermore, treatment strategies for changing resistance patterns are explored for community-acquired pneumonia during an influenza pandemic and infections with community-associated MRSA, extended-spectrum beta-lactamase producing organisms and fungi. Data for policy making are presented in articles that detail the costs of antimicrobial-resistant infections in healthcare settings and the threat of resistance with the introduction of antiretroviral therapy for large populations in the developing world. These reviews show where interventions, surveillance and research will be most useful in the future. Antimicrobial Resistance is an invaluable contribution for infectious disease physicians and public health officials who are interested in the prevention of antimicrobial-resistant infections.
Cover1
Contents6
Foreword8
Preface9
Community-Associated Methicillin Resistant Staphylococcus aureus12
Abstract12
S. aureus, MRSA and Community-Associated Infections: Background12
Rapid Increase in CA-MRSA Incidence14
Risk Factors, Clinical Manifestations and Transmission14
Differences between CA-MRSA and HA-MRSA16
Molecular Epidemiology of CA-MRSA16
Staphylococcal Chromosomal Cassette-Type Element17
Pathogenesis of CA-MRSA Infecti17
Virulence Factors20
Diagnosis20
Treatment21
Prevention25
References26
Infections with Organisms Producing Extended-Spectrum ß-Lactamase32
Abstract32
Introduction32
Host Range and Prevalence of ESBLs33
Risk Factors for Colonization and Infection with Hospital-Acquired ESBL Producers35
Risk Factors for Colonization and Infection with Health Care-Associated ESBL Producers35
Infection Control and ESBL-Producing Organisms36
Laboratory Detection of ESBL Production by Gram-Negative Bacilli38
Treatment of Infection with ESBL-Producing Organisms39
Conclusions40
References41
Fluoroquinolone Resistance: Challenges for Disease Control46
Abstract46
Mechanisms of Resistance48
Detection of Resistance in the Clinical Laboratory48
Prevalence of Resistance in Selected Pathogens49
Therapeutic and Public Health Implications of Resistance52
Drivers of Resistance54
Conclusion57
References57
Antibiotic Resistance and Community-Acquired Pneumonia during an Influenza Pandemic62
Abstract62
Epidemiology of Bacterial Community-Acquired Pneumonia During Inter-Pandemic Periods in the United States62
Biological Mechanisms for Interactions Between Influenza and Bacterial CAP64
Epidemiologic Evidence That Influenza Increases the Risk of Bacterial CAP65
Relationship Between Past and Future Pandemics71
Strategies for Reducing Secondary Pneumonia Caused by Resistant Bacteria during a Pandemic73
Future Directions75
Acknowledgments75
References75
Promoting Appropriate Antimicrobial Drug Use in the Outpatient Setting: What Works?81
Abstract81
Trends in Outpatient Antimicrobial Utilization83
Interventions to Improve Outpatient Antimicrobial Use84
Clinical Decision Support to Improve Antimicrobial Prescribing89
Health Plan Performance Measures to Promote Improved Prescribing90
AHRQ Analysis of Quality Improvement Strategies for Antimicrobial Prescribing91
Doctor-Patient Communication and Its Influence on Antimicrobial Prescribing93
Future Directions96
References97
Reducing Antimicrobial-Resistant Infections in Health Care Settings: What Works?100
Abstract100
Overview100
Antibiotic Control101
Infection-Control Practices103
Isolation Precautions107
Prevention of Infection to Prevent Resistance109
Future Approaches110
References111
Cost of Antimicrobial Resistance in Healthcare Settings: A Critical Review113
Abstract113
Global Estimates of Cost114
Perspective114
Literature Review114
Methodological Issues123
Cost of Prevention126
Future Directions128
References129
Mass Treatment of Parasitic Disease: Implications for the Development and Spread of Anthelmintic Resistance131
Abstract131
Mass Treatment of Parasitic Disease133
Summary of Main Mechanisms of Action in Anthelmintics136
Summary of Main Mechanisms of Resistance137
Molecular and Parasitological Evidence Suggesting the Development of Resistance in Filarial Parasites138
Factors Influencing the Spread of Anthelminthic Resistance139
Use of Mathematical Models141
Hookworm: Does Resistance Already Exist?144
Conclusions145
References146
Antifungal Drug Resistance: Clinical Importance, in vitro Detection and Implications for Prophylaxis and Treatment149
Abstract149
Invasive Fungal Infections149
Antifungal Drugs in Clinical Use151
Microbiological Resistance versus Clinical Resistance154
Prevention of Invasive Fungal Infections157
References159
Preparing for HIV Drug Resistance in the Developing World165
Abstract165
HIV Drug Resistance and Antiretroviral Treatment Scale-Up in Resource-Limited Countries165
HIV Drug Resistance Associated with Prevention of Mother-to-Child HIV Transmission172
Transmission of HIV Drug Resistance173
Summary175
References176
Author Index182
Subject Index183