Abstract
Emerging antimicrobial drug resistance in bacterial pathogens continues as a worsening problem, with 1997 seeing reports of multidrug resistant Streptococcus pneumoniae causing a nursing home outbreak in Oklahoma (Centers for Disease Control and Prevention. Outbreaks of pneumococcal pneumonia among unvaccinated residents in chronic-care facilities: Massachusetts, October, 1995, Oklahoma, February 1996, and Maryland, May–June 1996. MMWR Morb Mortal Wkly Rep . 1997;46:60–62) and the first report of Staphylococcus aureus no longer fully susceptible to vancomycin hydrochloride occurring inJapan (Hiramatsu K, Hanaki H, Ino T, et al. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother . 1997;40:135–136). To better deal with this rapidly developing problem, we present the second year’s national data for the United States that highlight the geographic nature of increasing resistance to antimicrobial agents. This year we are fortunate to add the cumulative 1996 information from the Cleveland (Ohio) Clinic to the US survey data. All laboratories sub-mitting information expended considerable effort to voluntarily compile the data. All participants were enthusiastic in this project and are to be commended, along with the American Society of Clinical Pathologists, for supporting this project. In 1996, the first areas were identified where 5% of Escherichia coli are resistant to ciprofloxacin, more than 10% of Klebsiella pneumoniae are resistant to ceftazidime, more than 10% of Enterobacter cloacae and Serratia marcescens are resistant to gentamicin, and, now, eight strains of Neisseria meningitidis with a minimum inhibitory concentration for penicillin of > 0.06 mg/mL have been detected. Added to the list of tables is one more emerging hospital pathogen, Acinetobacter calcoaceticus–Acinetobacter baumannii complex. It is more clear than ever that the future of infectious diseases and clinical microbiology remains filled with challenge.
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