ABSTRACT
Introduction ........................................................................................................ 364 Global Patterns of Resistance in Major Bacterial Pathogens ............................ 364
Acute Respiratory Infections .................................................................. 364 Diarrheal Diseases .................................................................................. 365
Shigella infections ........................................................................ 365 Cholera .......................................................................................... 366 Typhoid and Other Salmonella Infections ................................... 366
Sexually Transmitted Infections ............................................................. 367 Tuberculosis ............................................................................................ 367 Antibiotic Resistance in Health Care-Associated
(Nosocomial) Infections .................................................................. 368 The Clinical and Economic Impact of Antimicrobial Resistance ..................... 368 Laboratory and Epidemiological Issues in Relation to Resistance
Determination and Surveillance ............................................................. 368 Factors Contributing to the Emergence and Spread of
Antimicrobial Resistance ................................................................................ 369 Strategies for the Containment of the Global Occurrence and
Spread of Resistance ...................................................................................... 370 Improved Strategies for Antimicrobial Use ............................................ 370 Public Health Strategies ......................................................................... 370 Control of Health Care-Associated Infections ...................................... 371 Improved Laboratory Monitoring and Epidemiological Surveillance
of Resistant Bacteria .................................................................... 371 Development of New Antimicrobial Agents .......................................... 371
Conclusion .......................................................................................................... 372 References .......................................................................................................... 372
Bacterial resistance to antimicrobial agents is a global problem, affecting both industrialized and resource-poor countries. Such resistance increases the diffi culty of treating both community-and hospital-acquired infections, with a resulting effect on morbidity, mortality, and economic cost. There is a limited group of infections
responsible for the main burden of antimicrobial resistance, including acute respiratory infections, diarrheal disease, sexually transmitted infections, tuberculosis (TB), and health care-related (nosocomial) infections.
