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Colonisation and infection with resistant gram-positive cocci. Epidemiology and risk factors
1Department of Infectious Diseases, Uppsala University Hospital, Sweden.
Abstract:
Only a few years after the introduction of penicillin, resistant staphylococci were isolated in hospitals. This situation has led to the development of semisynthetic penicillins. Today, multiresistant Gram-positive bacteria have become an increasing problem in both hospitals and the community, frequently leaving the glycopeptides as the only therapeutic option. Notable problem pathogens are methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci and glycopeptide-resistant enterococci in the nosocomial environment, and penicillin-resistant Streptococcus pneumoniae in the community. In the hospital setting, as well as in the community and in animal husbandry, crowding and poor hygiene can facilitate the spread of resistant bacteria selected by antibiotic usage. However, the precise epidemiology and frequency of each drug-resistant pathogen depends on geographical location, the patient group involved and previous antibiotic use. Active measures need to be taken to reduce the spread of these pathogens and thus preserve the efficacy of available antibiotics.
Insights
Antibiotic resistance in bacteria like Staphylococcus and Streptococcus is a growing global health threat. Urgent measures are needed to curb the spread of resistant pathogens and preserve antibiotic effectiveness.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- The emergence of antibiotic resistance, exemplified by penicillin-resistant staphylococci shortly after penicillin's introduction, necessitates continuous development of antimicrobial agents.
- Multidrug-resistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), pose significant challenges in healthcare settings.
- Penicillin-resistant Streptococcus pneumoniae remains a concern in community-acquired infections.
Purpose of the Study:
- To highlight the escalating problem of multidrug-resistant bacteria in both hospital and community settings.
- To emphasize the diminishing therapeutic options, with glycopeptides often being the last resort.
- To underscore the need for active strategies to control the spread of resistant pathogens.
Main Methods:
- Review of historical and current trends in antibiotic resistance.
- Identification of key problematic bacterial pathogens and their resistance mechanisms.
- Analysis of factors contributing to the spread of resistant bacteria, including hospital and community environments.
Main Results:
- Rapid development of resistance to antibiotics like penicillin.
- Increasing prevalence of multidrug-resistant Gram-positive bacteria, including MRSA, coagulase-negative staphylococci, VRE, and penicillin-resistant Streptococcus pneumoniae.
- Identification of geographical location, patient demographics, and prior antibiotic exposure as critical epidemiological factors.
Conclusions:
- The rise of antibiotic-resistant bacteria necessitates a global approach to infection control and antibiotic stewardship.
- Factors such as crowding and poor hygiene exacerbate the spread of resistant strains.
- Preserving the efficacy of existing antibiotics requires active measures to reduce pathogen transmission and judicious use of antimicrobial agents.