The Global Spread of Healthcare-Associated Multidrug-Resistant Bacteria: a Perspective from Asia.
Clin Infect Dis. 2013 Jan 18;
Authors: Molton JS, Tambyah PA, Ang BS, Ling ML, Fisher DA
Since antibiotics were first used, each new introduced class has been followed by a global wave of emergent resistance, largely originating in Europe and North America where they were first used. MRSA spread from the UK and North America across Europe and then Asia over more than a decade. VRE and KPC-producing Klebsiella pneumoniae followed a similar path some 20 years later. Recently however, metallo-beta-lactamases have originated in Asia. NDM-1 was found in almost every continent within a year of its emergence in India. MBL enzymes are encoded on highly transmissible plasmids that spread rapidly between bacteria, rather than relying on clonal proliferation. Global air travel may have helped facilitate rapid dissemination. As the antibiotic pipeline offers little in the short term, our most important tools against the spread of antibiotic resistant organisms are intensified infection control, surveillance and antimicrobial stewardship.
PMID: 23334810 [PubMed - as supplied by publisher]