Resistant 'Superbugs' Create Need for Novel Antibiotics

Teri Capriotti, DO, MSN, CRNP


Dermatology Nursing. 2007;19(1):65-70. 

In This Article

Which Bacteria Are Called ‘Superbugs'?

In the 1990s, MRSA, VRSA, and VRE were the major superbugs which required clinical attention and pharmacological ingenuity. Sta phylococcus aureus and enterococcus were the glycopeptide-resistant gram-positive cocci of major concern. Some strains of staphylococcus, completely resistant to vancomycin, were called vancomycin-resistant staphylococcus aureus (VRSA). Some strains had some susceptibility to vancomycin and were called vancomycin intermediately susceptible staphylococcus aureus (VISA) or glycopeptide intermediately susceptible staph ylococcus aureus (GISA). This terminology also was used for enterococci: VRE and GRE (Pfeltz & Wilkinson, 2004; Shah, 2005).

As attention has been on staphylococcus and enterococcus for the past decade, another bacterium, streptococcus pneumoniae (also called pneumococcus), has been developing resistance. It classically has been a major cause of community-acquired infections, such as upper respiratory infections, bronchitis, pneumonia, otitis media, pharyngitis, and meningitis. Al though the bacterium was once eradicated easily with penicillin, significant antibiotic resistance has now become a major problem in strains of pneumococcus (Centers for Disease Control [CDC], 2003; Whitney et al., 2000).

Strains of S. pneumoniae have developed resistance to penicillin, trimethoprimsulfmeth oxazole (BactrimAE), macrolides (for example, azithromycin [Zith ro maxAE]), tetracyclines (for ex ample., minocycline [MinocinAE]), and fluoroquinolones (for example, ciprofloxacin [CiproAE]) (Hoff man-Roberts, Bab cock, & Mitro poulous, 2005; Karchmer, 2004). In 2002, the CDC reported that 34% of all S. pneumoniae infections were resistant to at least one antibiotic and 17% were resistant to three or more antibiotics (CDC, 2003). Drug-resistant streptococcus pneumoniae (DRSP) or penicillin-resistant streptococcus pneumoniae (PRSP) became the newest superbug of concern in 2002.

The trend of rising bacterial resistance continues to challenge health care providers. Antibiotic resistance has now become worthy of concern in pseudomonas aeruginosa, acinetobacter baumannii, and group A beta hemolytic streptococcus (GABHS, also called streptococcus pyogenes). These bacteria have not posed a major threat yet, but are anticipated to be the next highly resistant superbugs (Navon-Venezia, Ben-Ami, & Carmeli, 2005).

The health care literature uses a number of acronyms to describe the significant antibiotic-resistant bacteria which exist within the community and clinical settings. Nurses should be familiar with the terminology in Table 1 .


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