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Published on: July 7, 2020
Emergence and spread of antibiotic-resistant Gram-positive bacterial pathogens
Wolfgang Witte1, Christiane Cuny, Ingo Klare
1Robert Koch Institute, Wernigerode Branch, D-38855 Wernigerode, Germany. wittew@rki.de
Abstract:
Development of multiple resistances to antibiotics in staphylococci, enterococci and pneumococci became a health threat during the past 20 years, not only with respect to nosocomial infections. This resistance development is based on acquisition of resistance genes by predominant epidemic subpopulations (clonal complexes). Although emergence and spread of methicillin-resistant Staphylococcus aureus is associated with a limited number of epidemic clones which have been widely disseminated, acquisition of SCCmec elements by susceptible ancestors has taken place at different times and at different locations. Among Staphylococcus epidermidis and Enterococcus faecium, one clonal complex, which had acquired resistance genes at several occasions, is widely disseminated in hospitals. Also in Streptococcus pneumoniae, antibiotic resistance is preferentially associated with clonal lineages which have a capacity for spreading. They became, however, more rare after introduction of the 7-valent conjugate vaccine.
Insights
Antibiotic resistance in staphylococci, enterococci, and pneumococci is a growing health threat, driven by epidemic clones acquiring resistance genes. Vaccines have helped reduce resistance in some strains like Streptococcus pneumoniae.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Multiple antibiotic resistances in staphylococci, enterococci, and pneumococci pose a significant health threat, extending beyond hospital-acquired infections.
- The development of resistance is primarily linked to the acquisition of resistance genes by dominant epidemic bacterial subpopulations, known as clonal complexes.
Purpose of the Study:
- To investigate the mechanisms and dissemination patterns of antibiotic resistance in key bacterial pathogens.
- To understand the role of epidemic clones and mobile genetic elements in the spread of antimicrobial resistance.
Main Methods:
- Analysis of bacterial population structures and resistance gene acquisition.
- Epidemiological tracking of specific clones and resistance determinants.
- Comparative genomics to identify resistance mechanisms and evolutionary pathways.
Main Results:
- Methicillin-resistant Staphylococcus aureus (MRSA) emergence is linked to specific epidemic clones, though SCCmec element acquisition occurred independently.
- A single clonal complex in Staphylococcus epidermidis and Enterococcus faecium is widely disseminated in hospitals, acquiring resistance multiple times.
- Antibiotic resistance in Streptococcus pneumoniae is associated with specific, spreading lineages, with decreased prevalence after the introduction of the 7-valent conjugate vaccine.
Conclusions:
- Antibiotic resistance development is strongly associated with the clonal spread of specific bacterial lineages.
- Understanding clonal dynamics and gene acquisition is crucial for combating antimicrobial resistance.
- Vaccination strategies can impact the prevalence of antibiotic-resistant strains.
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