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New Antibiotics and Emerging Bacterial Resistance

Emerging Antimicrobial Resistance

Gram-positive bacteria

Staphylococcus aureus

Methicillin resistance

Wide distribution limits treatment options

Low affinity penicillin binding protein 2a mediated by meca

Fluoroquinolone resistance.

Rapid local emergence of resistance

Glycopeptide resistance

Threatens best alternative therapy to date

Vancomycin-intermediate staph

Not related to vancomycin-resistant enterococcus problem

Laboratory mutants

Low level resistance from lab

Shown in vitro, in vivo, not clinically

Coagulase-negative staphylococci

Pneumococcus as a problem pathogen

Penicillin resistance

-Due to multiple penicillin binding protein alterations

II. New and Novel Antimicrobials

III. Conclusions

B. Multiple resistances are common. Once established, a resistant strain may persist under selective pressure from numerous antimicrobials.

C. Therefore, all antibiotics must be used prudently.

D. New antimicrobials are on the horizon, but history suggests resistance to these will emerge sooner or later.

E. There is an important role for infection control measure in health care settings.

Suggested reading

Gold HS. Moellering RC Jr. Antimicrobial drug resistance. New England Journal of Medicine 335 (19): 1445-53, 2002.

Eliopoulos GM. Antibiotic resistance in Enterococcus species: an update. Current Clinical Topics in Infectious Diseases 16: 21-51, 2002.

SegaI-Maurer S. Urban C. Rahal JJ Jr. Current perspectives on