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Emerging antimicrobial resistance and the immunocompromised host
D M Shlaes1, B Binczewski, L B Rice
1Research Service, Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106.
Summary
Antimicrobial resistance in gram-positive bacteria is a growing threat, especially for immunocompromised patients. New treatments are limited, emphasizing careful antibiotic use and novel combination therapies to combat resistant infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Gram-positive bacterial infections are a major cause of illness in immunocompromised individuals.
- Antimicrobial resistance is escalating, particularly with enterococci and staphylococci.
Purpose of the Study:
- To highlight the critical issue of rising antimicrobial resistance in gram-positive pathogens.
- To discuss the challenges and potential strategies for managing infections caused by resistant bacteria.
Main Methods:
- Review of current trends in antimicrobial resistance among gram-positive bacteria.
- Analysis of emerging resistance mechanisms and their clinical implications.
Main Results:
- Key resistance issues include beta-lactam and aminoglycoside resistance in enterococci, methicillin-resistant staphylococci, vancomycin/teicoplanin resistance, and fluoroquinolone resistance.
- New classes of antibacterial drugs are unlikely to be available soon.
Conclusions:
- Judicious use of existing antibiotics and robust infection control are crucial.
- Exploring synergistic antibiotic combinations offers a promising therapeutic avenue for resistant infections.