Practical Management of Patients Infected with Resistant Organisms: An Infection Control Perspective

Abstract

Antibiotic resistant bacteria first became a major concern during the 1950’s with the emergence and widespread dissemination of penicillin-resistant strains of Staphylococcus aureus. However, in the 1970s and early 1980s, multi-drug resistant Gram-negative bacilli became the major problem confronting hospital-based infectious diseases clinicians and infection control programs.^1,2,3 More recently, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci have emerged as major nosocomial pathogens.^4,5,6 The emergence of multidrug resistant Gram-positive pathogens despite the use of accepted isolation procedures has prompted a reassessment of our approaches to infection control in the hospital setting. The purpose of this review is to discuss the epidemiology and prevention of resistant nosocomial pathogens, with emphasis on emerging Gram-positive pathogens.