<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902017000400104</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Alarma por la resistencia a antimicrobianos: situación actual y desafíos]]></article-title>
<article-title xml:lang="en"><![CDATA[Antimicrobial resistance alarm: current situation and challenges]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camou]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zunino]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hortal]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Programa de Desarrollo de Ciencias Básicas (PEDECIBA) ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Departamento de Microbiología Instituto de Investigaciones Biológicas Clemente Estable ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de la República Programa de Desarrollo de Ciencias Básicas (PEDECIBA) ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>4</numero>
<fpage>104</fpage>
<lpage>127</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902017000400104&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902017000400104&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902017000400104&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La creciente resistencia a los antimicrobianos (RAM) es un problema apremiante que de no combatirse a tiempo puede comprometer la salud de las generaciones futuras, con un retorno a la era preantibiótica. Frente a esa amenaza, los organismos sanitarios internacionales convocaron a todos los países para coordinar renovadas estrategias de lucha contra la RAM, promoviendo el enfoque de &#8220;una salud&#8221; con la participación de diferentes actores e instituciones. Este manuscrito proporciona información actualizada, explicando que la RAM no es más un dilema médico sino un fenómeno complejo que además afecta la producción agroveterinaria, el desarrollo y la economía de los países. La exposición a antibióticos contribuye a la selección de mutantes resistentes y favorece la transferencia horizontal de elementos genéticos móviles como plásmidos, integrones y tranposones que portan varios genes de resistencia contra distintas familias de antibióticos. Las antibioticoterapias, aun en situaciones justificadas, ejercen presiones selectivas que favorecen el predominio de mutantes bacterianas resistentes, por lo que es preciso evitar las infecciones, optimizando la higiene y el empleo de vacunas. También se ensayan terapias alternativas, por ejemplo basadas en bacteriófagos o probióticos. El Plan de Acción Mundial para controlar la RAM propuesto por la Organización Mundial de la Salud, la Organización Mundial de Salud Animal y la Organización de las Naciones Unidas para la Alimentación y el Desarrollo comprende cinco objetivos: mejorar la conciencia y el conocimiento sobre la resistencia antimicrobiana; reforzar la vigilancia y la investigación; reducir la incidencia de la infección; optimizar el uso de antimicrobianos, y asegurar una financiación duradera que asegure la persistencia de las acciones de control.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: The recent increase of antimicrobial resistance is a compelling problem that may compromise the health of future generations and result in us going back to the pre-antibiotic era, unless it is battled on time. In order to face this threat, global health organizations called countries to articulate new strategies to fight against antimicrobial resistance, by encouraging them to adopt a health centered approach that involves different actors and institutions. This report provides updated information, explaining the reasons why antimicrobial resistance is no longer a medical dilemma but rather a complex phenomenon that also affects agricultural and livestock production and the development and economy of countries. Antibiotic exposure contributes to the selection of resistant mutants and favors the horizontal transference of mobile genetic elements (MGE) such as plasmids, integrons and transposons, which carry several resistance genes against antibiotic families. Antibiotic therapy, still in justified situations, exerts selective pressure that favors the predominance of resistant bacteria mutants, and thus infections need to be avoided by optimizing hygiene conditions and relying on immunization. Also, alternative therapies are tried, as those based on bacteriophagists or probiotics. The Global Action Plan proposed by the WHO, the World Organization for Animal Health and the FAO to control antimicrobial resistance comprises five goals: to improve awareness and knowledge on antimicrobial resistance; to strengthen surveillance and research; to reduce the incidence of infection; to optimize the use of antimicrobial agents and to ensure a lasting funding that guarantees the continuation of control actions.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A crescente resistência aos antimicrobianos (RAM) é um problema grave que, se não for combatido rapidamente, pode comprometer a saúde das próximas gerações, com um retorno à era pré-antibiótica. Considerando esta ameaça, os organismos sanitários internacionais convocaram todos os países para coordenar novas estratégias de luta contra a RAM, promovendo um enfoque de saúde, com a participação de diferentes atores e instituições. Este manuscrito proporciona informação atualizada, explicando que a RAM não é mais um dilema médico, mas um fenómeno complexo que afeta também a produção agro veterinária, o desenvolvimento e a economia dos países. A exposição a antibióticos contribui para a seleção de mutantes resistentes e favorece a transferência horizontal de elementos genéticos móviles como plasmídeos, integrons e tranposons que portam vários genes de resistência contra distintas famílias de antibióticos. As antibioticoterapias, mesmo em situações justificadas, exercem pressões seletivas que favorecem o predomínio de mutantes bacterianos resistentes, e, portanto é preciso evitar as infeções, otimizando a higiene e o uso de vacinas. Também foram feitos ensaios com terapias alternativas, por exemplo, baseadas em bacteriófagos ou probióticos. O Plano de Ação Mundial para controlar a RAM, proposto pela OMS, OIE e FAO compreende cinco objetivos: melhorar a consciência e o conhecimento sobre resistência antimicrobiana; reforçar a vigilância e a pesquisa; reduzir a incidência das infecções; otimizar o uso de antimicrobianos, e garantir um financiamento duradouro que assegure a persistência das ações de controle.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Farmacorresistencia bacteriana]]></kwd>
<kwd lng="es"><![CDATA[Antibacterianos]]></kwd>
<kwd lng="es"><![CDATA[Salud global]]></kwd>
<kwd lng="es"><![CDATA[Planes y programas de salud.]]></kwd>
<kwd lng="en"><![CDATA[Bacterial drug resistance]]></kwd>
<kwd lng="en"><![CDATA[Anti-bacterial agents]]></kwd>
<kwd lng="en"><![CDATA[Global health]]></kwd>
<kwd lng="en"><![CDATA[Health programs and plans]]></kwd>
<kwd lng="pt"><![CDATA[Farmacorresistência bacteriana]]></kwd>
<kwd lng="pt"><![CDATA[Antibacterianos]]></kwd>
<kwd lng="pt"><![CDATA[Saúde global]]></kwd>
<kwd lng="pt"><![CDATA[Planos e programas de saúde.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[The evolving threat of antimicrobial resistance: options for action]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="book">
<collab>Organización Mundial de la Salud</collab>
<source><![CDATA[Resistencia a los antibióticos]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Ginebra ]]></publisher-loc>
<publisher-name><![CDATA[OMS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="book">
<collab>Organización Mundial de la Salud</collab>
<source><![CDATA[Plan de acción mundial sobre resistencia a os antimicrobianos]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Ginebra ]]></publisher-loc>
<publisher-name><![CDATA[OMS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Executive summary of the AVMA One Health Initiative Task Force report]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[King]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Anderson]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Blackmore]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
<name>
<surname><![CDATA[Blackwell]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lautner]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Marcus]]></surname>
<given-names><![CDATA[LC]]></given-names>
</name>
</person-group>
<source><![CDATA[J Am Vet Med Assoc]]></source>
<year>2008</year>
<volume>233</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>259-61</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Pan-resistant Acinetobacter infection in neonates in Karachi, Pakistan]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Saleem]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Mir]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ali]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Zaidi]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
</person-group>
<source><![CDATA[J Infect Dev Ctries]]></source>
<year>2009</year>
<volume>4</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>30-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="book">
<collab>Centers for Disease Control and Prevention</collab>
<source><![CDATA[Antibiotic resistance threats in the United States, 2013. Atlanta,]]></source>
<year>2014</year>
<publisher-loc><![CDATA[GA ]]></publisher-loc>
<publisher-name><![CDATA[CDC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Antibiotic resistance-the need for global solutions]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laxminarayan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Duse]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wattal]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Zaidi]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Wertheim]]></surname>
<given-names><![CDATA[HF]]></given-names>
</name>
<name>
<surname><![CDATA[Sumpradit]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2013</year>
<volume>13</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1057-98</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="book">
<collab>O´Neill J</collab>
<source><![CDATA[Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance]]></source>
<year>2016</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[AMR]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Predictors of carbapenem-resistant Klebsiella pneumoniae acquisition among hospitalized adults and effect of acquisition on mortality]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schwaber]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Klarfeld-Lidji]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Navon-Venezia]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Schwartz]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Leavitt]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carmeli]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2008</year>
<volume>52</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1028-33</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Global priority list of antibiotic-resistant bacteria to guide research, discovery and development of new antibiotics]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Geneva ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Characterization of a new metallo-beta-lactamase gene, bla (NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yong]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Toleman]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Giske]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
<name>
<surname><![CDATA[Cho]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Sundman]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[AntimicrobAgentsChemother]]></source>
<year>2009</year>
<volume>53</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>5046-54</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uruguay]]></surname>
</name>
</person-group>
<source><![CDATA[Ministerio de Salud Pública. Departamento de Laboratorios. Detección de enterobacterias productoras de carbapenemasas (EPC)]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Monevideo ]]></publisher-loc>
<publisher-name><![CDATA[MSP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="book">
<collab>General Assembly of United Nations</collab>
<source><![CDATA[71st session. Press release: high level meeting on antimicrobial resistance]]></source>
<year>2016</year>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[UN]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="book">
<collab>World Bank Group</collab>
<source><![CDATA[Final Report: drug-resistant infections. A threat to our economic future. Washington,]]></source>
<year>2017</year>
<publisher-loc><![CDATA[DC ]]></publisher-loc>
<publisher-name><![CDATA[World Bank]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The microbiome as a human organ]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baquero]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Nombela]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[ClinMicrobiol Infect]]></source>
<year>2012</year>
<volume>18</volume>
<numero>Suppl 4</numero>
<issue>Suppl 4</issue>
<page-range>2-4</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[From pieces to patterns evolutionary engineering in bacterial pathogens]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baquero]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[Nat Rev Microbiol]]></source>
<year>2004</year>
<volume>2</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>510-8</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Antibiotic resistance is prevalent in an isolated cave microbiome]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bhullar]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Waglechner]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pawlowski]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Koteva]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Banks]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
<name>
<surname><![CDATA[Johnston]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<source><![CDATA[PLos One]]></source>
<year>2012</year>
<volume>7</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e34953</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Origins and evolution of antibiotic resistance]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[MicrobiolMolBiol Rev]]></source>
<year>2010</year>
<volume>74</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>417-33</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[ARDB Antibiotic Resistance Genes Database]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Pop]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Nucleic Acids Res]]></source>
<year>2009</year>
<volume>37</volume>
<page-range>D443-7</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Co-selection of antibiotic and metal resistance]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baker-Austin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Stepanauskas]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[McArthur]]></surname>
<given-names><![CDATA[JV]]></given-names>
</name>
</person-group>
<source><![CDATA[Trends Microbiol]]></source>
<year>2006</year>
<volume>14</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>176-82</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Beta-lactamases of Kluyveraascorbata, probable progenitors of some plasmid-encoded CTX-M types]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Humeniuk]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Arlet]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Gautier]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Grimont]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Labia]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Philippon]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[AntimicrobAgentsChemother]]></source>
<year>2002</year>
<volume>46</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>3045-9</page-range></nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Enfermedades infecciosas emergentes en Uruguay memorias del siglo XX]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hortal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[García Gabarrot]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[An Fac Med Montev]]></source>
<year>2016</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>7-23</page-range></nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Levy]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
</person-group>
<source><![CDATA[The antibiotic paradox: how the misuse of antibiotics destroys their curative powers. 2 ed. Cambridge,]]></source>
<year>2002</year>
<publisher-loc><![CDATA[MA ]]></publisher-loc>
<publisher-name><![CDATA[Perseus Books Group]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Effect of pneumococcal conjugate vaccination in Uruguay, a middle-income country]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[García Gabarrot]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[López Vega]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez Giffoni]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cardinal]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Félix]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<source><![CDATA[PLoS One]]></source>
<year>2014</year>
<volume>9</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>e112337</page-range></nlm-citation>
</ref>
<ref id="B25">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Influence of patients' expectations on antibiotic management of acute lower respiratory tract illness in general practice questionnaire study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Macfarlane]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Holmes]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Macfarlane]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Britten]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<source><![CDATA[BMJ]]></source>
<year>1997</year>
<volume>315</volume>
<numero>7117</numero>
<issue>7117</issue>
<page-range>1211-4</page-range></nlm-citation>
</ref>
<ref id="B26">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Self-medication with antimicrobial drugs in Europe]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grigoryan]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Haaijer-Ruskamp]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
<name>
<surname><![CDATA[Burgerhof]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Mechtler]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Deschepper]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tambic-Andrasevic]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Emerg Infect Dis]]></source>
<year>2006</year>
<volume>12</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>452-9</page-range></nlm-citation>
</ref>
<ref id="B27">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Programa de optimización de uso de antimicrobianos (PROA) en hospitales españoles documento de consenso]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez Baño]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Paño Pardo]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Álvarez Rocha]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Asensio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Calbo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cercenado]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[EnfermInfeccMicrobiolClin]]></source>
<year>2012</year>
<volume>30</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>22e1-23</page-range></nlm-citation>
</ref>
<ref id="B28">
<nlm-citation citation-type="">
<source><![CDATA[Ordenanza 417/000: venta de antibióticos bajo receta profesional]]></source>
<year>2000</year>
</nlm-citation>
</ref>
<ref id="B29">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Reservoirs of antimicrobial resistance in pet animals]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lloyd]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2007</year>
<volume>45</volume>
<numero>Suppl 2</numero>
<issue>Suppl 2</issue>
<page-range>S148-52</page-range></nlm-citation>
</ref>
<ref id="B30">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mellon]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Benbrook]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lutz Benbrook]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Hogging it: Estimates of antimicrobial abuse in livestock. Cambridge,]]></source>
<year>2001</year>
<publisher-loc><![CDATA[MA ]]></publisher-loc>
<publisher-name><![CDATA[Union of Concerned Scientists]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B31">
<nlm-citation citation-type="book">
<collab>World Health Organization</collab>
<source><![CDATA[Regional Office for Europe. Tackling antibiotic resistance from a food safety perspective in Europe]]></source>
<year>2011</year>
<publisher-loc><![CDATA[Copenhagen ]]></publisher-loc>
<publisher-name><![CDATA[WHO]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B32">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Public health risks of enterobacterial isolates producing extended-spectrum beta-lactamases or AmpC beta-lactamases in food and food-producing animals an EU perspective of epidemiology, analytical methods, risk factors, and control options]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liebana]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Carattoli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Coque]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
<name>
<surname><![CDATA[Hasman]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Magiorakos]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Mevius]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2013</year>
<volume>56</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1030-7</page-range></nlm-citation>
</ref>
<ref id="B33">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[History of the use of antibiotic as growth promoters in European poultry feeds]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castanon]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
</person-group>
<source><![CDATA[PoultSci]]></source>
<year>2007</year>
<volume>86</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>2466-71</page-range></nlm-citation>
</ref>
<ref id="B34">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Restricting antimicrobial use in food animals: lessons from Europe banning nonessential antibiotic uses in food animals is intended to reduce pools of resistance genes]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cogliani]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Goossens]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Greko]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Microbe]]></source>
<year>2011</year>
<volume>6</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>274-9</page-range></nlm-citation>
</ref>
<ref id="B35">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A review of antibiotic use in food animals perspective, policy, and potential]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Landers]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Wittum]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
<name>
<surname><![CDATA[Larson]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
</person-group>
<source><![CDATA[Public Health Rep]]></source>
<year>2012</year>
<volume>127</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>4-22</page-range></nlm-citation>
</ref>
<ref id="B36">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pulcini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bush]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Craig]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
<name>
<surname><![CDATA[Frimodt-Møller]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Grayson]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Mouton]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Forgotten antibiotics an inventory in Europe, the United States, Canada, and Australia]]></article-title>
<collab>ESCMID Study Group for Antibiotic Policies</collab>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2012</year>
<volume>54</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>268-74</page-range></nlm-citation>
</ref>
<ref id="B37">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[Y-Y]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Walsh]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Yi]]></surname>
<given-names><![CDATA[LX]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Spencer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Lancet Infect Dis]]></source>
<year>2016</year>
<volume>16</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>161-8</page-range></nlm-citation>
</ref>
<ref id="B38">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Phage therapy in bacterial infections treatment one hundred years after the discovery of bacteriophages]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cisek]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Dbrowska]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Gregorczyk]]></surname>
<given-names><![CDATA[KP]]></given-names>
</name>
<name>
<surname><![CDATA[Wyzewski]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<source><![CDATA[CurrMicrobiol]]></source>
<year>2017</year>
<volume>74</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>277-83</page-range></nlm-citation>
</ref>
<ref id="B39">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prokaryotes the unseen majority]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Whitman]]></surname>
<given-names><![CDATA[WB]]></given-names>
</name>
<name>
<surname><![CDATA[Coleman]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Wiebe]]></surname>
<given-names><![CDATA[WJ]]></given-names>
</name>
</person-group>
<source><![CDATA[ProcNatlAcadSci USA]]></source>
<year>1998</year>
<volume>95</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>6578-83</page-range></nlm-citation>
</ref>
<ref id="B40">
<nlm-citation citation-type="">
<article-title xml:lang=""><![CDATA[Lecciones aprendidas en el estudio y diagnóstico de la infección por Clostridiumdifficile en el Hospital "Manuel Quintela"]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seija]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Balsamo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Palacio]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Menéndez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Batista]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Calata]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Academia Nacional de Medicina. Gran Premio Nacional de Medicina]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B41">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prospects for 'competitive exclusion' treatment to control salmonellas and other foodborne pathogens in poultry]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mead]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
</person-group>
<source><![CDATA[Vet J]]></source>
<year>2000</year>
<volume>159</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>111-23</page-range></nlm-citation>
</ref>
<ref id="B42">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Fecal transplantation for the treatment of Clostridium difficile infection]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Brandt]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
</person-group>
<source><![CDATA[GastroenterolHepatol]]></source>
<year>2012</year>
<volume>8</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>191-4</page-range></nlm-citation>
</ref>
<ref id="B43">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Torres Manrique]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[La resistencia bacteriana a los antibióticos, siete décadas después del Fleming]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Zaragoza ]]></publisher-loc>
<publisher-name><![CDATA[Colegio Oficial de Farmacéuticos]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
