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Confronting bacterial resistance in healthcare settings: a crucial role for microbiologists

Nature Reviews Microbiology volume 2, pages 251–258 (2004)Cite this article

Abstract

Bacteria that are resistant to antimicrobial agents, which were previously isolated primarily in acute-care hospitals, now cause infection in a wide range of other healthcare settings. Improved detection of new resistant strains — especially by using practical and affordable screening methods and by evaluating mechanisms of resistance — is a priority for tackling this problem effectively. Standardized, effective surveillance systems for evaluating the emergence and prevalence of resistant strains are necessary to assess the success of intervention strategies.

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Figure 1: Prevalence of resistance by organism/drug combination and hospital setting.
Figure 2: Prevalence of methicillin-resistant Staphylococcus aureus by year and hospital area.
Figure 3: Prevalence of ciprofloxacin-resistant Pseudomonas aeruginosa by year and hospital area.
Figure 4: Mechanisms of spread of bacterial resistance.

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Acknowledgements

The authors thank D. Shapiro and M. Barlow for helpful discussions.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, 30322, Georgia, USA

    John E. McGowan Jr

  2. Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, 30333, Georgia, USA

    Fred C. Tenover

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  1. John E. McGowan Jr
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  2. Fred C. Tenover
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Corresponding author

Correspondence to John E. McGowan Jr.

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Competing interests

Research by Project ICARE is funded by Abbott Laboratories; AstraZeneca; Bayer Corporation, Pharmaceuticals Division; Cubist; Elan Pharmaceuticals; Pfizer, Inc.; and Roche Laboratories.

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DATABASES

Infectious Disease Information

MRSA

pneumonia

VISA

VRE

VRSA

FURTHER INFORMATION

Antimicrobial Resistance Info Bank

European Antimicrobial Resistance Surveillance System

ISO

Project ICARE

The Institute for Genomic Research S. aureus Michigan VRSA genome

Glossary

ANTIBIOGRAM

The results of all susceptibility tests for a given organism considered as an overall group. The term is often used to refer both to such a profile for an individual organism and to cumulative summaries of such profiles for a given period of time.

ANTIBIOTYPE

The subgroup into which a bacterial organism is classified on the basis of a comparison of its antibiogram with those of organisms of the same genus and species. The antibiotype is the result of the application of a typing system on the basis of this phenotypic characterization.

CLONAL DISSEMINATION

The spread of a single strain of a bacterial organism, or of a single resistance determinant, in a given geographical area, or the introduction of such a strain or element from a geographically distant population.

LOCAL SELECTION

The proliferation and spread, usually under the influence of local antimicrobial use, of resistant bacteria that have either accumulated mutations that reduce their susceptibility to antimicrobial agents or have acquired novel resistance genes by direct DNA transfer

PRINCIPAL-COMPONENT ANALYSIS

A means of representing multidimensional data in a reduced-dimension space to obtain an overview of the data.

ZONE DIAMETER

The measurement (in millimetres) of the diameter of the zone of inhibition of organism growth around a disk that contains a standard amount of an antimicrobial agent. Used in one method of standardized susceptibility testing (agar-disk diffusion) to define the activity of the drug against a bacterial organism.

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McGowan, J., Tenover, F. Confronting bacterial resistance in healthcare settings: a crucial role for microbiologists. Nat Rev Microbiol 2, 251–258 (2004). https://doi.org/10.1038/nrmicro845

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