Infect Chemother.  2011 Dec;43(6):443-449. 10.3947/ic.2011.43.6.443.

Antimicrobial Resistance in Gram-positive Cocci: Past 50 Years, Present and Future

Affiliations
  • 1Division of Infectious Diseases, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea. songjh@skku.edu
  • 2Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea.

Abstract

Widespread development of antimicrobial resistance by major bacterial pathogens including Staphylococcus aureus, Streptococcus pneumoniae, Enterococci, and gram-negative bacilli have emerged as a global healthcare concern. Antimicrobial resistance was first identified during the 1940s and 50s with penicillin resistance in S. aureus. During the 1970s and 80s, methicillin-resistant S. aureus (MRSA) rapidly emerged as a major nosocomial pathogen in hospitals throughout the world. In the 1990s, a variation of MRSA emerged as community-associated MRSA (CA-MRSA), which is contracted outside of the hospital setting, and has become one of the most common pathogens associated with skin and skin structure infections in the United States and other parts of the world. Vancomycin-intermediate S. aureus (VISA) was first reported in 1996, and high-level vancomycin-resistant S. aureus (VRSA) was reported in 2002. S. pneumoniae has demonstrated a significant increase in resistance to macrolides and beta-lactam agents since 1980s, particularly in Asian countries while penicillin resistance is not prevalent among non-meningeal isolates according to the new breakpoints from CLSI. Vancomycin resistant enterococci, particularly E. faecium, is a major concern associated with nosocomial infections in many hospitals. Given the widespread emergence and spread of antimicrobial resistant gram-positive cocci during recent decades, the problem is likely to continue to increase as a critical, clinical problem.

Keyword

Antimicrobial resistance; Gram-positive cocci; Staphylococcus aureus; Streptococcus pneumoniae; Enterococci

MeSH Terms

Asian Continental Ancestry Group
Contracts
Cross Infection
Delivery of Health Care
Gram-Positive Cocci
Humans
Macrolides
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Penicillin Resistance
Pneumonia
Skin
Staphylococcus aureus
Streptococcus pneumoniae
United States
Vancomycin
Macrolides
Vancomycin

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