Bacteria for the nineties

Ostomy Wound Manage. 1998 Aug;44(8):32-40; discussion 34-8; quiz 41-2.

Abstract

Staphylococcus aureus and Enterococci have gained prominence as the causes of wound infections during this decade. Methicillin-resistant Staphylococcus aureus (MRSA) became commonplace in the United States during the 1980s. In Canada, infections with MRSA have been increasing in frequency since 1995. MRSA develops resistance by producing an altered penicillin-binding protein, PBP 2a, coded for by the mecA gene. Vancomycin is the usual drug of choice. Recently, strains with intermediate resistance to vancomycin (VISA) have been isolated from patients in Japan and the United States. Interim guidelines for their control have been developed by the Centers for Disease Control. Enterococci have developed a resistance to a variety of antimicrobials during the past three decades, including beta-lactams and aminoglycosides. Recently, strains resistant to vancomycin (VRE) have been found in the United States and Canada. They are particularly difficult to treat, although some success has been achieved with experimental drugs. These microorganisms have the ability to escape control by antimicrobials almost as soon as they are developed. Thus, we must practice good infection control and reserve antimicrobials only for clear cases of infection if we are to prevent or delay the emergence of resistance.

Publication types

  • Review

MeSH terms

  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology*
  • Bacterial Infections / prevention & control
  • Drug Resistance, Microbial
  • Enterococcus
  • Humans
  • Infection Control / methods*
  • Staphylococcus aureus
  • Wound Infection / drug therapy*
  • Wound Infection / microbiology*
  • Wound Infection / prevention & control