Antimicrobial resistance in gram-positive bacteria
1Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. louis.rice@med.va.gov
The American Journal of Medicine
|June 1, 2006
Summary
Antibiotic-resistant Gram-positive bacteria, including MRSA and VRE, are increasing in hospitals. Vaccines show promise in combating the spread of these resistant infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Gram-positive bacteria are a significant cause of hospital-acquired infections in the US.
- Increasing rates of antibiotic resistance in Gram-positive bacteria, specifically Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE), are a growing concern.
- Hospital-acquired MRSA (HA-MRSA) often spreads through patient-to-patient contact, facilitated by healthcare workers, and is frequently multidrug-resistant.
Purpose of the Study:
- To review the current landscape of antibiotic-resistant Gram-positive bacterial infections in healthcare settings.
- To highlight the challenges posed by MRSA and VRE, including their resistance mechanisms and modes of transmission.
- To explore potential strategies for combating the spread of these resistant pathogens.
Main Methods:
- Review of current literature and epidemiological data on Gram-positive bacterial infections.
- Analysis of resistance patterns and mechanisms for MRSA and VRE.
- Evaluation of the impact of interventions such as vaccination on resistant bacterial infections.
Main Results:
- MRSA accounts for a substantial percentage of staphylococcal infections in US intensive care units, with increasing prevalence.
- Vancomycin resistance in Enterococci (VRE) is rising, with Enterococcus faecium being the predominant species involved in hospital infections.
- Emergence of vancomycin-resistant S aureus (VRSA) has been noted, alongside increasing community-acquired MRSA (CA-MRSA) infections, which often have broader antibiotic susceptibility than HA-MRSA.
- The 7-valent pneumococcal conjugate vaccine has led to a decline in invasive pneumococcal disease.
Conclusions:
- Antibiotic resistance in Gram-positive bacteria, particularly MRSA and VRE, poses a significant threat in healthcare settings.
- Understanding transmission dynamics and resistance mechanisms is crucial for effective control.
- Vaccination strategies may play a role in mitigating the spread of resistant Gram-positive cocci.
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