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[Staphylococci resistant to antibiotic therapy]
1Service de microbiologie, centre hospitalier et universitaire de la Côte-de-Nacre, 14033 Caen, France. leclercq-r@chu-caen.fr
Abstract:
Increasing frequency in antibiotic resistance in Staphylococcus aureus is worrying. In this review, we briefly describe the mechanisms of resistance to antibiotics in staphylococci and we report the current incidence of antibiotic resistance in France. Methicillin-resistance is mostly confined to hospitals. However, spread of multiply resistant strains of staphylococci to the community is a putative threat. Strains with diminished susceptibility to glycopeptides are rare but possibly underestimated because of the in vitro difficulties to detect glycopeptide resistance. A continuous resistance survey is necessary. The problem of multiresistance is different for hospital and community staphylococci. The later strains still remain susceptible to many antibiotics, apart from some exceptions. By contrast, incidence of multiply resistance in hospitals remains high. After a recent decrease, incidence of oxacillin resistance seems to be stabilized. A new and recent feature is the great variety of resistance phenotypes which can be found in methicillin-resistant strains, in particular with gentamicin susceptibility.
Insights
Antibiotic resistance in Staphylococcus aureus is a growing concern. While hospital-acquired infections show high rates of multi-drug resistant strains, community spread poses a future threat, necessitating ongoing surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Context:
- Staphylococcus aureus antibiotic resistance is increasing globally.
- Methicillin-resistant Staphylococcus aureus (MRSA) is primarily a hospital-associated issue.
- Community-acquired infections by resistant staphylococci are an emerging concern.
Purpose:
- To review antibiotic resistance mechanisms in staphylococci.
- To report the current incidence of antibiotic resistance in Staphylococcus aureus in France.
- To highlight the challenges in detecting resistance, particularly to glycopeptides.
Summary:
- Antibiotic resistance in Staphylococcus aureus is a significant public health concern.
- Hospital-acquired infections exhibit high rates of multiply resistant strains, including MRSA.
- Community-acquired strains, while generally less resistant, present a potential future threat.
- Glycopeptide resistance is rare but may be underestimated due to detection difficulties.
- Oxacillin resistance incidence appears stable after a recent decline.
- Methicillin-resistant strains display a wide variety of resistance phenotypes, notably concerning gentamicin susceptibility.
Impact:
- Informs public health strategies for controlling antibiotic resistance.
- Highlights the need for continuous resistance surveillance.
- Guides clinical management of Staphylococcus aureus infections.
- Emphasizes the importance of accurate in vitro susceptibility testing.
- Underscores the distinct resistance challenges in hospital versus community settings.