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Gram-positive Bacterial Infections

Gram-positive bacteria, such as Staphylococcus, Streptococcus, Enterococcus, Listeria, and Clostridium are responsible for a large proportion of serious infections worldwide. Gram-positive organisms, including S. aureus and Enterococcus, were among the top 10 most frequently isolated organisms based on the recent update from the National Healthcare Safety Network (NHSN) surveillance of antimicrobial-resistant pathogens associated with healthcare-associated infections reports.11 Moreover, these gram positive organisms were found to be among the most commonly isolated organisms in hospitals in Europe as well.13 There were an estimated 478,000 hospitalizations with S. aureus infection in the US in 2005.1,5

Gram Positive Bacteria
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Cubist is proud to be a meaningful contributor toward the Infectious Diseases Society of America’s (IDSA) call for the development of 10 new systemic antibacterial drugs by 20204, by targeting drug development within the gram positive as well as gram negative space.

A growing proportion of Gram-positive organisms display reduced susceptibility to first-line therapies.6,9,14 Bacterial resistance to antibiotics in both the community and hospital settings increases the likelihood of poor clinical outcomes.2,8,10,14 Consequently, resistant bacteria, such as methicillin-resistant S. aureus (MRSA), have a significant impact on overall healthcare utilization and costs.2,14

The prevalence of MRSA varies by region, but NHSM notes that more than 50% of nosocomial S. aureus isolates are methicillin resistant.11 In the past, infections due to MRSA were mostly limited to the hospital setting. However, in the last 10 years, there has been considerable growth of community-associated MRSA strains as well.12 For instance, in patients admitted to emergency wards with skin and soft tissue infections in 11 US cities, 59% were reported as MRSA. 7

Thus, newer Gram-positive agents, both oral and IV, are still needed for use in the treatment of community- and hospital-acquired infections.9

References

  • Centers for Disease Control and Prevention. MRSA Surveillance. Assessed September 9, 2013.
  • Cosgrove SE, Qi Y, Kaye KS, et al. The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges. Infect Control Hosp Epidemiol. 2005;26(2):166-74.
  • Gorwitz RJ, Kruszon-Moran D, McAllister SK, et al. Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001-2004. J Infect Dis. 2008;197(9):1226-34.
  • Infectious Diseases Society of America: America, The 10 × ′20 Initiative: pursuing a global commitment to develop 10 new antibacterial drugs by 2020. Clin Infect Dis. 2010;50(8):1081–1083.
  • Klein E, Smith DL, Laxminarayan R. Hospitalizations and deaths caused by methicillin-resistant Staphylococcus aureus, United States, 1999-2005. Emerg Infect Dis. 2007;13(12):1840-6.
  • Lode H. Management of serious nosocomial bacterial infections: do current therapeutic options meet the need? Clin Microbiol Infect. 2005;11(10):778-87.
  • Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006;355(7):666–674.
  • Pendleton JN, Gorman SP, Gilmore BF: Clinical relevance of the ESKAPE pathogens. Expert Rev Anti Infect Ther. 2013;11:297–308.
  • Rybak JM, Barber KE, Rybak MJ. Current and prospective treatments for multidrug-resistant gram-positive infections. Expert Opin Pharmacother. 2013 [Epub ahead of print].
  • Santayana EM, Grim SA, Janda WM, et al. Risk factors and outcomes associated with vancomycin-resistant Enterococcus infections with reduced susceptibilities to linezolid. Diagn Microbiol Infect Dis.2012;74(1):39-42.
  • Sievert DMP, Ricks PP, Edwards JRMS, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2009--2010. Infect Control Hosp Epidemiol. 2013;34(1):1-14.
  • Urbina O, Ferrández O, Espona M, et al. Potential role of tedizolid phosphate in the treatment of acute bacterial skin infections. Drug Des Devel Ther. 2013;7:243-65.
  • Vincent JL, Rello J, Marshall J, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302(21):2323-9.
  • Woodford N, Livermore DM. Infections caused by Gram-positive bacteria: a review of the global challenge. J Infect. 2009 Sep;59 Suppl 1:S4-16.