Question

Why are staphlyococcus, streptococcus and enterococcus species major concerns in the healthcare environment?

Answer 1

Staphylococcus aureus are common bacteria that spread in healthcare facilities and the community. Methicillin resistant S. aureus (MRSA) can capregnant women carry GBS bacteria in their body. use difficult to treat staph infections because of resistance to some antibiotics.MRSA has become resistant to many first-line antibiotics. People who inject drugs are more vulnerable to MRSA infection than those who do not. CDC (center for disease control and prevention) recommended interventions to prevent the spread of MRSA reduced rates of MRSA by 55% between 2005 and 2017. This included screening all patients for MRSA on admission, tracking MRSA infections, using Contact Precautions (such as gloves and gowns) for people with MRSA, and increasing the emphasis on hand hygiene.

Streptococcus pneumoniae (pneumococcus) is a leading cause of bacterial pneumonia and meningitis. It also is a common cause of bloodstream infections, and ear and sinus infections. In more than 30% of infections, the bacteria are resistant to one or more clinically relevant antibiotics. Group B Streptococcus (GBS) is a type of bacteria that can cause severe illnesses including bloodstream infections, pneumonia, meningitis, and skin infections in people of all ages. GBS causes infections among pregnant women, older adults, and people with certain medical conditions, such as diabetes. Mothers who test positive for GBS during pregnancy can pass GBS to their newborns.Healthcare providers give these mothers penicillin or ampicillin during labor to prevent the spread of GBS to newborns during birth. Clindamycin-resistant strains of GBS have caused more than 40% of GBS infections, limiting prevention and treatment options for people with severe penicillin allergy. Group A Streptococcus (GAS) bacteria can cause mild infections such as sore throat and impetigo, and severe invasive disease such as cellulitis, pneumonia, flesh-eating infections, and sepsis. Increasing resistance to erythromycin and clindamycin complicates treatment of GAS infections. GAS is not resistant to penicillin or amoxicillin so clindamycin, in combination with penicillin, is the recommended treatment for severe, lifethreatening GAS infections such as flesh-eating disease and streptococcal toxic shock syndrome. More than one in five invasive GAS infections are caused by erythromycin and clindamycin resistant strains, limiting the patient’s treatment options. vaccines are in development stage but it will take time to be available for use.

Enterococci, a type of bacteria, can cause serious infections for patients in healthcare settings, including bloodstream, surgical site, and urinary tract infections. About 30% of all healthcare-associated enterococcal infections are resistant to vancomycin, reducing treatment options. These entercoccus species are called vancomycin resistant enterococci (VRE).  VRE infection are more common in patients who stay in long-term  intensive care units undergoing organ transplant, or receiving treatment for certain types of cancer whose immunity is very weak. In solid organ transplant units, one type of VRE , Enterococcus faecium is the most common cause of central line-associated bloodstream infections. More than 70% of these E. faecium are resistant to vancomycin, a mainstay for treating these infections. This makes healthcare providers reliant on other antibiotics.Maintaining and improving infection prevention and control interventions, such as hand hygiene and surface disinfection, is critical to further reduce the number of VRE infections and protect vulnerable patient populations.