title: Antimicrobial resistance: current status and future direction.
abstract: BACKGROUND
  Antimicrobial resistance is initiated through mutations in bacterial genes, culminating in end products that help circumvent the action of specific antimicrobial agents. Resistant mutants can proliferate under a number of circumstances but primarily through the action of selective pressure from the overuse of antimicrobial agents.
  
  
  METHODS
  The results of surveillance studies over approximately the last ten years were evaluated.
  
  
  CONCLUSIONS
  Resistance rates in the group of microorganisms associated with respiratory tract infections had been increasing rapidly over the past 10 years, but, recently, many seem to have reached a plateau. However, newer, more invasive clones of methicillin resistant Staphylococcus aureus (MRSA), differing from health care-associated MRSA (HA-MRSA), and typically associated with community-acquisition (CA-MRSA), recently have begun to proliferate. Burgeoning use of fluoroquinolones has impacted the Gram-negative bacilli (e.g., Pseudomonas aeruginosa, Escherichia coli, and Salmonella), causing their resistance rates to approach the critical point. A better understanding of the epidemiology of resistance and responsible use of antimicrobial agents are mandatory if the continuing rates of increasing resistance are to be abrogated.
authors.affiliation: Division of Infectious Diseases, Laboratory Sciences of Arizona/Sonora Quest Laboratories, Banner Health, and University of Arizona College of Medicine, Phoenix/ Tucson, Arizona 85006, USA. mike.saubolle@bannerhealth.com
authors.forename: Michael A
authors.initials: MA
authors.lastname: Saubolle
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000254:growth & development; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents