Evolving Resistance Among Gram-positive Pathogens
Clinical Infectious Diseases SEP 15, 2015 V.61 Suppl.2 S48-S57
Jose M. Munita, Arnold S. Bayer, and Cesar A. Arias
1Division of Infectious Diseases, Department of Internal Medicine
2Department of Microbiology and Molecular Genetics, University of Texas Medical School at Houston
3Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance
4David Geffen School of Medicine at UCLA, Los Angeles, California
5International Center for Microbial Genomics
6Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia
7Clinica Alemana de Santiago, Universidad del Desarrollo, Chile
Correspondence: Cesar A. Arias, MD, PhD, University of Texas Medical School at Houston, 6431 Fannin St, MSB 2.112, Houston, TX 77030 (firstname.lastname@example.org).
Antimicrobial therapy is a key component of modern medical practice and a cornerstone for the development of complex clinical interventions in critically ill patients.
Unfortunately, the increasing problem of antimicrobial resistance is now recognized as a major public health threat jeopardizing the care of thousands of patients worldwide.
Gram-positive pathogens exhibit an immense genetic repertoire to adapt and develop resistance to virtually all antimicrobials clinically available. As more molecules become available to treat resistant gram-positive infections, resistance emerges as an evolutionary response.
Thus, antimicrobial resistance has to be envisaged as an evolving phenomenon that demands constant surveillance and continuous efforts to identify emerging mechanisms of resistance to optimize the use of antibiotics and create strategies to circumvent this problem.
Here, we will provide a broad perspective on the clinical aspects of antibiotic resistance in relevant gram-positive pathogens with emphasis on the mechanistic strategies used by these organisms to avoid being killed by commonly used antimicrobial agents.