Organisms of concern

Antimicrobial resistance is increasing in many pathogens. Problem organisms include:

• Streptococcus pneumoniae
• methicillin-resistant Staphylococcus aureus (MRSA) in both healthcare and community settings
• vancomycin-resistant enterococci (VRE)
• strains of Klebsiella and Escherichia coli that produce extended-spectrum beta-lactamase (ESBL) enzymes
• Neisseria gonorrhoeae
• multidrug-resistant Acinetobacter and Pseudomonas aeruginosa.

The emergence of carbapenemase-producing Enterobacterales (CPE) is particularly concerning, and has placed greater emphasis on the need for ‘one health’ antimicrobial stewardship programs. A ‘one health’ approach recognises that the health of humans, animals and the environment are closely linked, and that action is required in all sectors where antimicrobials are used to reduce the threat of antimicrobial resistance (see the National Centre for Antimicrobial Stewardship website).

Emergence of resistance to ‘reserve’ antimicrobials – such as quinolones, carbapenems, vancomycin, colistimethate sodium (colistin) – is a major public health challenge.