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Published on: May 2, 2018
Evolving resistance among Gram-positive pathogens
Jose M Munita1, Arnold S Bayer2, Cesar A Arias3
1Division of Infectious Diseases, Department of Internal Medicine International Center for Microbial Genomics Clinica Alemana de Santiago, Universidad del Desarrollo, Chile.
Abstract:
Antimicrobial therapy is a key component of modern medical practice and a cornerstone for the development of complex clinical interventions in critically ill patients. Unfortunately, the increasing problem of antimicrobial resistance is now recognized as a major public health threat jeopardizing the care of thousands of patients worldwide. Gram-positive pathogens exhibit an immense genetic repertoire to adapt and develop resistance to virtually all antimicrobials clinically available. As more molecules become available to treat resistant gram-positive infections, resistance emerges as an evolutionary response. Thus, antimicrobial resistance has to be envisaged as an evolving phenomenon that demands constant surveillance and continuous efforts to identify emerging mechanisms of resistance to optimize the use of antibiotics and create strategies to circumvent this problem. Here, we will provide a broad perspective on the clinical aspects of antibiotic resistance in relevant gram-positive pathogens with emphasis on the mechanistic strategies used by these organisms to avoid being killed by commonly used antimicrobial agents.
Insights
Antimicrobial resistance in gram-positive pathogens is a growing public health threat. This review details the clinical challenges and emerging resistance mechanisms to optimize antibiotic use and patient care.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial therapy is crucial for treating critically ill patients.
- Antimicrobial resistance (AMR) poses a significant global health threat.
- Gram-positive pathogens demonstrate remarkable adaptability to antimicrobial agents.
Purpose of the Study:
- To provide a clinical perspective on antibiotic resistance in gram-positive pathogens.
- To highlight the evolving nature of antimicrobial resistance.
- To emphasize the need for continuous surveillance and strategy development.
Main Methods:
- Literature review of clinical aspects of antibiotic resistance.
- Analysis of mechanistic strategies employed by gram-positive pathogens.
- Focus on emerging resistance to commonly used antimicrobial agents.
Main Results:
- Gram-positive bacteria possess extensive genetic mechanisms for resistance.
- Resistance emerges as an evolutionary response to new antimicrobial molecules.
- Understanding these mechanisms is key to optimizing antibiotic therapy.
Conclusions:
- Antimicrobial resistance in gram-positive pathogens requires ongoing monitoring.
- Identifying emerging resistance mechanisms is essential for effective treatment strategies.
- Continuous efforts are needed to circumvent resistance and preserve antibiotic efficacy.
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