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Updated: Mar 24, 2026
High-throughput Fluorometric Measurement of Potential Soil Extracellular Enzyme Activities
Published on: November 15, 2013
[Not Available]
Abstract:
Infections with multi-drug resistant bacteria are increasing worldwide. Glycopeptides, linezolid, daptomycin and 5th generation cephalosporins ("MRSA-cephalsoporins") are used against severe infections with MRSA, combination partners are rifampin and fosfomycin. Treatment options against VRE-infections are limited to linezolid, daptomycin and tigecyclin. New agents with activity against MRSA and VRE are tedizolid, dalbvancin and oritavancin. For monotherapy of severe infections due to 3MRGN carbapenems are available. Ceftolozane/tazobactam has been licensed by the European Medical Agency and shows good activity against a relevant proportion of ESBL-pathogens. Oral agents such as nitrofurantoin or fosfomycin are used for treatment of uncomplicated cystitis. Colistin shows best in vitro susceptibility against carbapenem-resistant Enterobacteriaceae, followed by fosfomycin and tigecycline. For serious infections with 4MRGN a colistin-based combination treatment with two to three agents is recommended. In such cases a carbapenem as combination partner may be useful.
Insights
Multi-drug resistant bacterial infections are a growing global threat. This review outlines current and emerging treatments for MRSA, VRE, and carbapenem-resistant Enterobacteriaceae, highlighting key agents and combination therapies.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Rising global incidence of multi-drug resistant (MDR) bacterial infections.
- Limited treatment options for severe infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE).
- Increasing challenge posed by carbapenem-resistant Enterobacteriaceae (CRE) and other extensively drug-resistant Gram-negative bacteria (XDR-GNB).
Purpose of the Study:
- To review current therapeutic strategies for MDR bacterial infections.
- To highlight novel antimicrobial agents with activity against MRSA and VRE.
- To discuss treatment recommendations for infections caused by 3- and 4- kháng sinh kháng thuốc Gram-negative bacilli (3MRGN and 4MRGN).
Main Methods:
- Literature review of antimicrobial agents and treatment guidelines.
- Analysis of in vitro susceptibility data for key pathogens.
- Evaluation of clinical efficacy for selected antimicrobial therapies.
Main Results:
- Established agents for MRSA include glycopeptides, linezolid, daptomycin, and 5th generation cephalosporins, often used with rifampin or fosfomycin.
- Treatment for VRE is primarily limited to linezolid, daptomycin, and tigecycline.
- New agents like tedizolid, dalbavancin, and oritavancin show promise against MRSA and VRE.
- Carbapenems are options for 3MRGN monotherapy; ceftolozane/tazobactam is effective against ESBL-pathogens.
- Colistin demonstrates best in vitro activity against CRE, followed by fosfomycin and tigecycline.
- Colistin-based combination therapy is recommended for serious 4MRGN infections, potentially including carbapenems.
Conclusions:
- Effective management of MDR bacterial infections requires a strategic approach utilizing available and emerging antimicrobial agents.
- Combination therapies are crucial for treating severe infections caused by highly resistant pathogens like CRE.
- Continued research and development of new antibiotics are essential to combat the evolving threat of antimicrobial resistance.
