PROBLEMS AND PRIORITIES FOR CONTROLLING OPPORTUNISTIC PATHOGENS WITH NEW ANTIMICROBIAL STRATEGIES - AN OVERVIEW OF CURRENT LITERATURE

An International Study Group on New Antimicrobial Strategies (ISGNAS) has been formed in response to the recognition that development of mic robial resistance to antibiotics is becoming a serious, world-wide pro blem. The group met in 1993 for the first time to discuss the feasibil ity of developing rational alternatives to the use of antibiotics and prepared, as a result, a comprehensive overview of normal (physiologic al) mechanisms involved in the control of potentially pathogenic (oppo rtunistic) microorganisms. One objective of ISGNAS is to understand th e conditions which allow opportunistic microbes present among the symb ionts to cause an infection. There is a need for more coherent informa tion concerning the habitat, growth requirements and host and pathogen properties which allow opportunistic pathogens to cause life-threaten ing infections. In particular, information is urgently being sought to understand the complexity of the interactions between the vast number of microbial species, and the interactions between the microbes and t heir host. Another goal is to inspire and enable basic and clinical re search that will lead to the development of new therapies for regulati ng colonization, translocation and infection by opportunistic micro-or ganisms in patients during periods of decreased resistance. With a suf ficient amount of knowledge of how healthy individuals keep opportunis tic micro-organisms under control, it may become feasible for physicia ns to maintain host resistance and inter-microbial factors involved in the containment of opportunistic microbes. Therapies aimed at booster ing natural resistance mechanisms will be of critical importance to in dividuals whose resistance has been compromised as a result of another clinical condition.