[Clinical and epidemiological repercussions of bacterial resistance]

Following the observation of a high percentage of bacterial resistance to antibiotics, the mechanisms of the establishment and transmission of such resistances on an extra-chromosomal basis (R factors) are examined in detail. After noting that the increased incidence and spread of bacterial strains resistant to chemotherapeutic substances and antibiotics is caused by the widespread use of antibiotics in the zootechnical field, the use of antimicrobic substances for food conservation, the increasing use of broad spectrum antibiotics and the rapid selection of resistant Gram-negative strains in hospitals, the clinical and epidemiological effects of antibiotic resistance in the Enterobacteriaceae are considered. The situation in Italy is looked at in particular where multiresistance to antibiotics promoted by R factors, already widespread in northern Italy, is being presently extended to southern Italy. It is hoped that physicians will realise the immediate and future epidemiological effects of the indiscriminate employment of broad spectrum antibiotics as this inevitably leads to the establishment of multiple resistance factors in Gram-negative bacterial populations.