文本框: ANTIMICROBIAL RESISTANCE IN PAEDIATRIC INFECTIOUS DISEASES Michael Nissen MD Department of Infectious Diseases, Royal Children’s Hospital, Brisbane, Australia. The consideration of antimicrobial resistant pathogens is becoming an increasingly important problem in the management of infectious illnesses in children worldwide. The problem of antimicrobial resistance occurs in both community and nosocomial health care settings. Resistance to antimicrobials is as seen in a wide range of bacterial infections, as well as in selected viral, fungal and parasitic diseases. Resistance may be due to an inherent tendency on the part of the organism (e.g. Stenotrophomonas and Acinetobacter), or result from the overuse of antibiotics with a high potential for the development of resistance in treating certain conditions (e.g. Streptococcus pneumoniae, vancomycin resistant enterococci and Plasmodium falciparum). Also, the development of broad spectrum antibiotics and the increasing survival of critically ill children through invasive interventions combine to create new reserviors of resistant pathogens. In general the epidemiologic characteristics of the common antimicrobial resistant bacteria, viruses, fungi and parasites e.g. Streptococcus pneumoniae, methicillin resistant Staphylococcus aureus, cytomegalovirus, HIV, non-Candida albicans spp., and Plasmodium falciparum are well-defined. The current global situation, management of, and control strategies for selected diseases will be discussed.