The problem of the battle between mankind and a whole plethora of
pathogens was touched upon in my January 2007 article in the ABJ. This
is not a fight we can win; we make advances and then they do. This
issue has implications for honey bee health as much as human and the
health of all organisms that are affected by our care or lack of it.

> Recent advances in molecular epidemiological methods have elucidated the evolutionary pathways by which modern methicillin-resistant Staphylococcus aureus have evolved. Only five major lineages of hospital methicillin-resistant Staphylococcus aureus exist, but these are globally distributed and evolving resistance to even the newest antibiotics.

> Staphylococcus aureus (Staph infection) is one of the major resistant pathogens. Found on the mucous membranes and the skin of around a third of the population, it is extremely adaptable to antibiotic pressure. It was the first bacterium in which penicillin resistance was found -- in 1947, just four years after the drug started being mass-produced. Staphylococcus aureus can cause a range of illnesses from minor skin infections, such as pimples, impetigo to life-threatening diseases, such as pneumonia, meningitis, Toxic shock syndrome, and septicemia.


* * *

Antimicrobial Resistance Trends and Outbreak Frequency in United
States Hospitals

> We assessed resistance rates and trends for important antimicrobial-resistant pathogens (oxacillin-resistant Staphylococcus aureus [ORSA], etc.  Resistance rates were highest for ORSA (36%). Two-thirds of hospitals reported increasing ORSA rates, whereas only 4% reported decreasing rates, and 24% reported ORSA outbreaks within the previous year. Most hospitals (87%) reported having implemented measures to rapidly detect resistance, but only 50% reported having provided appropriate resources for antimicrobial resistance prevention (53%) or having implemented antimicrobial use guidelines (60%). The most common resistant pathogen in US hospitals is ORSA, which accounts for many recognized outbreaks and is increasing in frequency in most facilities. Current practices to prevent and control antimicrobial resistance are inadequate.

> The data we report have important implications. A more aggressive approach to the prevention and control of antimicrobial resistance is needed.

> The Antimicrobial Availability Task Force of the Infectious Diseases Society of America has viewed with concern the decreasing investment by major pharmaceutical companies in antimicrobial research and development. Although smaller companies are stepping forward to address this gap, their success is uncertain. The IDSA proposed legislative and other federal solutions to this emerging public health problem in its July 2004 policy report "Bad Bugs, No Drugs: As Antibiotic R&D Stagnates, a Public Health Crisis Brews."

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