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Antimicrobial pressure and the emergence and spread of multiresistant enterococci

L B Rice1

  • 1Louis Stokes Veterans Administration Medical Center and Case Western Reserve University School of Medicine, 10701 East Boulevard, Cleveland, OH 44106, USA. louis.rice@med.va.gov

Postgraduate Medicine
|August 12, 2009
PubMed

Insights

Multiresistant enterococci, particularly vancomycin-resistant enterococci (VRE), are a growing threat in hospitals. Antibiotic use and poor infection control fuel VRE spread, necessitating better strategies.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Antimicrobial Resistance

Background:

  • Multiresistant enterococci, especially Enterococcus faecium, are significant nosocomial pathogens.
  • The rise of vancomycin and ampicillin resistance in E. faecium is a major concern in tertiary care settings.
  • Failure to implement infection control measures and sustained antibiotic pressure contribute to pathogen spread.

Purpose of the Study:

  • To examine the factors contributing to the emergence and spread of multiresistant enterococci in hospitals.
  • To investigate the role of specific antibiotic classes in the dissemination of vancomycin-resistant enterococci (VRE).
  • To identify key areas for improving control strategies against these resistant pathogens.

Main Methods:

  • Review of accumulating clinical data and epidemiological trends.
  • Analysis of the impact of antimicrobial selective pressures on VRE colonization.
  • Assessment of the effectiveness of current infection control practices.

Main Results:

  • Extended-spectrum cephalosporins and certain anaerobic antibacterials are implicated in VRE spread.
  • These antibiotics may differentially affect VRE colonization establishment and persistence.
  • Inadequate adherence to infection control measures is a critical factor.

Conclusions:

  • Controlling multiresistant enterococci requires understanding specific antimicrobial impacts.
  • Renewed commitment to established infection control measures is essential.
  • Further research into antimicrobial pressures is needed for effective VRE containment.

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