Abstract

Nursing homes and other long-term care facilities (LTCFs) have traditionally been viewed as reservoirs for antibacterial agent-resistant bacteria. Because urinary tract infection is one of the leading causes of infections in this population, Gramnegative microorganisms rapidly developed high levels of resistance to antimicrobial agents. However, the incidence of infections with resistant Gram-positive cocci increased significantly during the 1990s. The emergence of methicillin-resistant Staphylococcus aureus (MRSA) was followed by the appearance of Streptococcus pneumoniae resistant to penicillin and other antibiotics and vancomycin-resistant enterococci (VRE). In addition, the frequency of infections produced by these organisms is increasing, particularly among patients with serious medical conditions. Thus, new and effective antimicrobial agents are needed to treat patients with multidrug-resistant Gram-positive cocci. I would like to consider the factors that induce the appearance and spread of microorganism in general, and Grampositive cocci in particular, in LTCFs. The development of new antibiotics against multiresistant Gram-positive cocci infections and their specific indications will also be discussed. THE PROBLEM

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