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Antibiotic resistance among clinically important gram-positive bacteria in the UK
1Antibiotic Reference Laboratory, Central Public Health Laboratory, Colindale, London, UK.
Abstract:
The resistance of bacteria to antibiotics, particularly those used for first-line therapy, is an increasing cause for concern. In the UK, the prevalence of resistance to methicillin and mupirocin in Staphylococcus aureus, and to penicillin and macrolides in Streptococcus pneumoniae, appear to be increasing. There has also been an increase in the number of hospitals where glycopeptide-resistant enterococci are known to have been isolated. The increases in methicillin-resistant S. aureus and glycopeptide-resistant enterococci are due, in part, to the inter-hospital spread of epidemic strains. Although new quinolones and streptogramins with activity against Gram-positive bacteria (including strains resistant to currently available agents) are under development, there is no reason to believe that resistance to these agents will not emerge. The control of resistance in Gram-positive bacteria will require a multi-faceted approach, including continued and improved surveillance, a reduction in the unnecessary use of antibiotics, and the application of other strategies such as vaccination.
Insights
Antibiotic resistance in bacteria like Staphylococcus aureus and Streptococcus pneumoniae is rising, posing a significant public health threat. Controlling this requires better surveillance, reduced antibiotic use, and strategies like vaccination.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Increasing bacterial resistance to antibiotics, especially first-line treatments, is a growing global concern.
- Specific rising resistance includes methicillin-resistant Staphylococcus aureus (MRSA), mupirocin-resistant S. aureus, penicillin-resistant Streptococcus pneumoniae, macrolide-resistant S. pneumoniae, and glycopeptide-resistant enterococci (GRE).
- The spread of epidemic strains between hospitals contributes to the rise of MRSA and GRE.
Purpose of the Study:
- To highlight the increasing prevalence of antibiotic resistance in key bacterial pathogens.
- To discuss the contributing factors, including inter-hospital spread of resistant strains.
- To emphasize the need for a comprehensive strategy to combat emerging antibiotic resistance.
Main Methods:
- This study is a review and analysis of current trends in antibiotic resistance.
- It synthesizes data on resistance patterns in Staphylococcus aureus and Streptococcus pneumoniae.
- It also considers the emergence of glycopeptide-resistant enterococci in hospital settings.
Main Results:
- Prevalence of resistance to methicillin and mupirocin in Staphylococcus aureus is increasing in the UK.
- Resistance to penicillin and macrolides in Streptococcus pneumoniae is also on the rise.
- There is an observed increase in hospital-acquired infections with glycopeptide-resistant enterococci.
Conclusions:
- Emerging resistance to new antibiotics like quinolones and streptogramins is anticipated.
- A multi-faceted approach is essential for controlling Gram-positive bacterial resistance.
- Key strategies include enhanced surveillance, judicious antibiotic use, and vaccination programs.
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