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January 24, 1996

The Challenges of Emerging Infectious DiseasesDevelopment and Spread of Multiply-Resistant Bacterial Pathogens

Author Affiliations

From the National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga.

JAMA. 1996;275(4):300-304. doi:10.1001/jama.1996.03530280052036

THE LIST of emerging infectious diseases is an intriguing constellation of new entities (a previously unrecognized Hantavirus), recognized pathogens that have caused recent outbreaks of unprecedented size (Cryptosporidium in municipal water supplies), outbreaks that have culminated in a reassessment of the issue of food safety (Escherichia coli O157:H7), and traditional nosocomial and community-acquired infections that, due to their resistance to multiple antimicrobial agents, have suggested the possibility of a postantibiotic era.1,2Enterococcus faecium, Streptococcus pneumoniae, and Mycobacterium tuberculosis are just a few of the organisms that have become considerably more difficult to treat due to increasing drug resistance. Examples of the types of resistant bacteria that have emerged around the world are shown in Figure 1, while specific examples of emerging resistance problems in the United States are shown in Figure 2. Clearly, the emergence of resistant organisms has been a global phenomenon. A recent Institute of Medicine report