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Antimicrobial-resistant bacteria in the community setting

Nature Reviews Microbiology volume 4, pages 36–45 (2006)Cite this article

Abstract

Over the past decade, antimicrobial resistance has emerged as a major public-health crisis. Common bacterial pathogens in the community such as Streptococcus pneumoniae have become progressively more resistant to traditional antibiotics. Salmonella strains are beginning to show resistance to crucial fluoroquinolone drugs. Community outbreaks caused by a resistant form of Staphylococcus aureus, known as community-associated meticillin (formerly methicillin)-resistant Staphylococcus aureus, have caused serious morbidity and even deaths in previously healthy children and adults. To decrease the spread of such antimicrobial-resistant pathogens in the community, a greater understanding of their means of emergence and survival is needed.

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Figure 1: Rates of prescriptions for the 'common cold', upper-respiratory-tract infections (URIs) and bronchitis in children and adolescents.
Figure 2: Horizontal gene transfer between bacteria.
Figure 3: Correlation between penicillin use and prevalence of penicillin-non-susceptible Streptococcus pneumoniae.
Figure 4: Factors that contribute to the spread of antimicrobial resistance in the community.

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Acknowledgements

E.Y.F. is supported by a National Institutes of Health (NIH) training grant. F.D.L. is supported by grants from the Center for Disease Control and Prevention, NIH Grants and by a grant from the National Center for Research Resources, NIH, that supports the Center for Interdisciplinary Research on Antimicrobial Resistance.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, Columbia University, College of Physicians & Surgeons, 630 West 168th Street, New York, 10032, New York, USA

    E. Yoko Furuya & Franklin D. Lowy

  2. Department of Pathology, Columbia University, College of Physicians & Surgeons, 630 West 168th Street, New York, 10032, New York, USA

    Franklin D. Lowy

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  1. E. Yoko Furuya
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Correspondence to E. Yoko Furuya.

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DATABASES

Entrez

Clostridium difficile

Pseudomonas aeruginosa

Salmonella Typhimurium DT104

Staphylococcus aureus

Staphylococcus epidermidis

Streptococcus pneumoniae

FURTHER INFORMATION

Alliance for the Prudent Use of Antibiotics

FDA bans enrofloxacin use in poultry

NARMS

Glossary

Minimum inhibitory concentration

The lowest concentration of an antibiotic that inhibits growth of the organism.

Clonal dissemination

The spread of one or several clones of an organism throughout a region or population.

Folliculitis

An infection of the skin localized to the hair follicles. Lesions are erythematous and sometimes pustular.

Infective endocarditis

An infection of a heart valve that can lead to tissue destruction, valvular dysfunction, stroke and heart failure.

Necrotizing pneumonia

A severe, often fulminant, infection of the lungs with tissue destruction caused both by the pathogen and by the response of the host immune system.

Necrotizing fasciitis

A deep infection of subcutaneous tissue resulting in progressive destruction of the fascial and fat layers. It can spread rapidly and is associated with a high mortality if not treated early.

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Furuya, E., Lowy, F. Antimicrobial-resistant bacteria in the community setting. Nat Rev Microbiol 4, 36–45 (2006). https://doi.org/10.1038/nrmicro1325

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