Antimicrobial resistance in hospitals: How concerned should we be?

Mulvey, Michael R.; Simor, Andrew E.
February 2009
CMAJ: Canadian Medical Association Journal;2/17/2009, Vol. 180 Issue 4, p408
Academic Journal
The article focuses on the mechanisms of antibiotic resistance and impact of multidrug-resistant organisms in hospitals. It delineates the genetics of antibiotic resistance that varies between intrinsic resistance and acquired resistance. It highlights the mechanisms of antibiotic resistance including enzymatic inactivation of drugs, structural modifications to the antibiotic target site, and alterations that forbid access of adequate concentration of antibiotics to the active site. It outlines how antimicrobial-resistance bacteria are transmitted through selective pressure and clonal transmission. Multidrug-resistant organisms, which include Clostridium difficile, Enterococcus, and Staphylococcus aureus, that can be found in hospitals as well as its increasing impact are cited.


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