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      Multiple-drug resistant enterococci: the nature of the problem and an agenda for the future.

      review-article
      , ,
      Emerging Infectious Diseases
      Centers for Disease Control

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          Abstract

          Enterococci, leading causes of nosocomial bacteremia, surgical wound infection, and urinary tract infection, are becoming resistant to many and sometimes all standard therapies. New rapid surveillance methods are highlighting the importance of examining enterococcal isolates at the species level. Most enterococcal infections are caused by Enterococcus faecalis, which are more likely to express traits related to overt virulence but--for the moment--also more likely to retain sensitivity to at least one effective antibiotic. The remaining infections are mostly caused by E. faecium, a species virtually devoid of known overt pathogenic traits but more likely to be resistant to even antibiotics of last resort. Effective control of multiple-drug resistant enterococci will require 1) better understanding of the interaction between enterococci, the hospital environment, and humans, 2) prudent antibiotic use, 3) better contact isolation in hospitals and other patient care environments, and 4) improved surveillance. Equally important is renewed vigor in the search for additional drugs, accompanied by the evolution of new therapeutic paradigms less vulnerable to the cycle of drug introduction and drug resistance.

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          Author and article information

          Journal
          Emerg Infect Dis
          eid
          Emerging Infectious Diseases
          Centers for Disease Control
          1080-6040
          1080-6059
          Apr-Jun 1998
          : 4
          : 2
          : 239-249
          Affiliations
          University of Oklahoma Health Sciences Center 73190, USA.
          Article
          10.3201/eid0402.980211
          2640141
          9621194
          6f3ea3d1-5457-4bb6-95ff-b68f987c8f9f
          History
          Categories
          Research Article

          Infectious disease & Microbiology
          Infectious disease & Microbiology

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