- “A disturbing consequence of antibiotic treatment has been the long-term
persistence of antibiotic resistance genes, for example in the human gut. These
data warrant use of prudence in the administration of antibiotics that could
aggravate the growing battle with emerging antibiotic-resistant pathogenic
strains.” - “Increasing antimicrobial resistance is a growing threat to human health and is
mainly a consequence of excessive use of antimicrobial agents in clinical
medicine.” - “It is important to also consider the role of the enormously diverse human
commensal microbiota. It is generally acknowledged that the use of antibiotics
causes selection for and enrichment of antimicrobial resistance, but it has also
been believed until recently that the commensal microbiota is normalized a few
weeks following withdrawl of the treatment.” - Also see Appendix 3, Commensals: Underappreciated Reservoir of Antibiotic
Resistance. (Marshall ____) IS the appendix in this same text?
Jones, K., Patel, N., Levy, M., et al. (2008). Global trends in emerging infectious
diseases. Nature. 451. pg. 990-3.
http://www.nature.com/nature/journal/v451/n7181/abs/nature06536.html
- “Colonization of in-dwelling catheters leads to biofilm formation and results in
catheters serving as sources of continual infection in patients.”
Jones A., Kuijper E. and Wilcox, M. (2013). Clostridium difficile: A European
perspective. Journal of Infectious Disease. 66(2). pg. 115-28.
http://www.ncbi.nlm.nih.gov/pubmed/23103666
- “Clostridium difficile infection is the leading cause of diarrhoea in the
industrialised world. First identified in 1935, our knowledge about the clonal
population structure, toxins and PCR ribotypes is still increasing. New PCR
ribotypes and sequence types are frequently added. In the last decade
hypervirulent strains have emerged and been associated with increased severity
of disease, high recurrence and significant mortality. Although previously a
primarily hospital- or health-care acquired infection, since the 1990's C. difficile
infections that are community-acquired have been increasingly reported. Risk
factors include hospitalisation, advancing age and prior antibiotic use. The
ubiquitous presence of C. difficile in the environment and asymptomatic
intestinal colonisation may be important reservoirs for infection and the changing
epidemiology of C. difficile infection. Although surveillance in Europe is now a