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Clinical Microbiology and InfectionVolume 15 Issue 3, Pages 209 - 211
EDITORIAL
Fighting infections due to multidrug-resistant Gram-positive pathogens
编辑评论：应对多重耐药革兰阳性菌的挑战
G. Cornaglia Guest Editor Dipartimento di Patologia, Università di Verona, Verona, Italy
E-mail: giuseppe.cornaglia@univr.it
Copyright Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases
Clin Microbiol Infect 2009; 15: 209–211
ABSTRACT
Growing bacterial resistance in Gram-positive pathogens means that what were once effective and inexpensive treatments for infections caused by these bacteria are now being seriously questioned, including penicillin and macrolides for use against pneumococcal infections and—in hospitals—oxacillin for use against staphylococcal infections. As a whole, multidrug-resistant (MDR) Gram-positive pathogens are rapidly becoming an urgent and sometimes unmanageable clinical problem. Nevertheless, and despite decades of research into the effects of antibiotics, the actual risk posed to human health by antibiotic resistance has been poorly defined; the lack of reliable data concerning the outcomes resulting from antimicrobial resistance stems, in part, from problems with study designs and the methods used in resistence determination. Surprisingly little is known, too, about the actual effectiveness of the many types of intervention aimed at controlling antibiotic resistance. New antibiotics active against MDR Gram-positive pathogens have been recently introduced into clinical practice, and the antibiotic pipeline contains additional compounds at an advanced stage of development, including new glycopeptides, new anti-methicillin-resistant Staphylococcus aureus (MRSA) β-lactams, and new diaminopyrimidines. Many novel antimicrobial agents are likely to be niche products, endowed with narrow antibacterial spectra and/or targeted at specific clinical problems. Therefore, an important educational goal will be to change the current, long-lasting attitudes of both physicians and customers towards broad-spectrum and multipurpose compounds. Scientific societies, such as the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), must play a leading role in this process.
Clinical Microbiology and InfectionVolume 15 Issue 3, Pages 212 - 217
REVIEW
Clinical impact of antibiotic-resistant Gram-positive pathogens
耐药革兰阳性菌的临床影响
H. M. Lode RCMS, Affiliated Institute for Clinical Pharmacology and Toxicology, Charité– Universitätsmedizin Berlin, Berlin, Germany
Corresponding author and reprint requests: H. M. Lode, Research Centre for Medical Studies (RCMS), Hohenzollerndamm 2/D-10717 Berlin, Germany
http://www.rcms-berlin.de
E-mail: haloheck@zedat.fu-berlin.de
Copyright Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases
KEYWORDS
Clinical impact • drug-resistant pneumococci • MRSA • review • VRE
Clin Microbiol Infect 2009; 15: 212–217
ABSTRACT
The European Union's attention to the problem of antibacterial resistance will soon reach a 10-year mark, but the rates of resistance in Gram-positive and Gram-negative bacteria are still increasing. This review focuses on the clinical impact of resistant Gram-positive bacteria on patients. Multiple drug resistance in pneumococcal infections will lead to more treatment failures and higher mortality, which so far have been seen with penicillins and pathogens with high-level resistance. Several studies have demonstrated higher mortality, prolonged length of hospital stay and higher costs associated with methicillin-resistant Staphylococcus aureus infections, in comparison with methicillin-susceptible Staphylococcus aureus infections. Similarly, vancomycin-resistant enterococci bloodstream infections have a negative impact with respect to mortality, length of hospital stay and costs, in comparison with infections due to vancomycin-susceptible enterococci. Several distinctive prophylactic and therapeutic approaches have to be undertaken to successfully prevent the clinical consequences of antibiotic resistance in Gram-positive bacteria. This review addresses the impact of antibiotic-resistant Gram-positive pathogens on clinical outcomes.
Clinical Microbiology and InfectionVolume 15 Issue 3, Pages 218 - 223
REVIEW
Forthcoming therapeutic perspectives for infections due to multidrug-resistant Gram-positive pathogens
多重耐药革兰阳性菌感染目前的治疗观点
G. Cornaglia 1 and G. M. Rossolini 2,3 [url=] [/url] 1) Dipartimento di Patologia, Sezione di Microbiologia, Università di Verona, Verona , [url=] [/url] 2) Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena and [url=] [/url] 3) Dipartimento dei Servizi, Unita Operativa di Microbiologia e Virologia, Azienda Ospedaliera-Universitaria Senese, Siena, Italy
Corresponding author and reprint requests: G. M. Rossolini, Dept. of Molecular Biology, Section of Microbiology, University of Siena, Italy
E-mail: rossolini@unisi.it
Copyright Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases
KEYWORDS
Antimicrobial agents • Gram-positive pathogens • multidrug resistance • review
Clin Microbiol Infect 2009; 15: 218–223
ABSTRACT
Multidrug resistance in Gram-positive pathogens emerged as a major therapeutic challenge over two decades ago. The worldwide spread of methicillin-resistant Staphylococcus aureus (MRSA), glycopeptide-resistant enterococci and other resistant Gram-positive pathogens had a major impact on antibiotic policies, and prompted the discovery and development of new antibiotics to combat difficult-to-treat infections caused by such pathogens. Several new antibiotics active against multidrug-resistant Gram-positive pathogens have recently been introduced into clinical practice, and the antibiotic pipeline contains additional anti-Gram-positive drugs at an advanced stage of development, including new glycopeptides (dalbavancin, oritavancin, and telavancin), new anti-MRSA β-lactams (ceftobiprole), and new diaminopyrimidines (iclaprim). This article provides a brief overview of these upcoming agents, partially based on the material presented at the ESCMID Conference entitled 'Fighting infections due to multidrug-resistant Gram-positives' (Venice, Italy, 29–31 May 2008) and on the most recent literature.
Clinical Microbiology and InfectionVolume 15 Issue 3, Pages 224 - 231
REVIEW
Epidemiological and resistance issues in multidrug-resistant staphylococci and enterococci
多重耐药葡萄球菌和肠球菌的流行病学和耐药情况
R. Leclercq Department of Microbiology, CHU Côte de Nacre and EA 2128, University of Caen-Basse-Normandie, Caen, France
Corresponding author and reprint requests: R. Leclercq, Service de Microbiologie, University of Caen-Basse-Normandie, CHU de Caen, avenue Côte de Nacre, 14033 Caen cedex,
France
E-mail: [email=leclercq-r@chu-caen.fr]leclercq-r@chu-caen.fr[/email]
Copyright Journal compilation © 2009 European Society of Clinical Microbiology and Infectious Diseases
KEYWORDS
Antibiotic resistance • carriage • Gram-positive • multidrug resistance • outbreaks • review • virulence
Clin Microbiol Infect 2009; 15: 224–231
ABSTRACT
The spread of methicillin-resistant Staphylococcus aureus is continuous. The emergence of community-acquired methicillin-resistant S. aureus (CA-MRSA) was rapidly followed by its introduction into and dissemination in hospitals in countries where CA-MRSA prevalence is high. Vancomycin-resistant enterococci have recently been responsible for outbreaks in European hospitals in relation to dissemination of hospital-adapted isolates. Although new antimicrobials have been recently introduced into therapy to fight multidrug-resistant Gram-positive cocci, resistance to these compounds has already emerged in rare strains. This review presents recent data concerning the advance of our knowledge related to these problems. |
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发表于 2009-3-23 16:33
发表于 2009-3-23 18:43