Document Detail


Overview of resistant gram-positive pathogens in the surgical patient.
MedLine Citation:
PMID:  12594908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Staphylococci and enterococci are the most common pathogens in surgical-site and bloodstream infections. The emergence of drug resistance among these gram-positive bacteria thus poses a substantial threat to patients with surgical infections. Resistance to methicillin/oxacillin is frequently observed in Staphylococcus aureus isolates and is often accompanied by multidrug resistance. Vancomycin is usually the treatment of choice for infections caused by methicillin-resistant S. aureus (MRSA), so the recent appearance of S. aureus isolated with intermediate sensitivity to vancomycin is cause for concern. Vancomycin resistance has already appeared in most species of enterococci. Infections caused by vancomycin-resistant enterococci (VRE) are associated with increased mortality compared to infections caused by vancomycin-sensitive isolates. Measures for preventing vancomycin resistance include reducing the use of vancomycin and other agents that appear to be associated with VRE, including third-generation cephalosporins and anti-anaerobic drugs. Third-generation cephalosporins have also been implicated in the increased prevalence of MRSA infections. Prudent use of existing antibiotics is an essential strategy for combating the rising tide of drug-resistant gram-positive pathogens.
Authors:
R P Rapp
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Surgical infections     Volume:  1     ISSN:  1096-2964     ISO Abbreviation:  Surg Infect (Larchmt)     Publication Date:  2000  
Date Detail:
Created Date:  2003-02-21     Completed Date:  2003-04-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9815642     Medline TA:  Surg Infect (Larchmt)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-47     Citation Subset:  IM    
Affiliation:
Division of Pharmacy Practice and Science, University Hospital, University of Kentucky Medical School, Lexington, KY 40536-0082, USA. rprapp01@pop.uky.edu
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MeSH Terms
Descriptor/Qualifier:
Cross Infection / drug therapy*,  microbiology
Drug Resistance, Bacterial* / genetics
Enterococcus faecalis / drug effects
Gram-Positive Bacteria / drug effects*,  genetics
Gram-Positive Bacterial Infections / drug therapy*,  epidemiology
Humans
Infection Control
Practice Guidelines as Topic
Staphylococcus aureus / drug effects
Surgical Procedures, Operative
Surgical Wound Infection / drug therapy*,  microbiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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