ENTEROBACTER SPP - PATHOGENS POISED TO FLOURISH AT THE TURN-OF-THE-CENTURY

Knowledge of the genus Enterobacter and its role in human disease has expanded exponentially in recent years. The incidence of infection in the hospital and the community has increased. New clinical syndromes h ave been recognized. Enterobacter spp. have also been implicated as ca uses of other syndromes that traditionally have been associated almost exclusively with more easily treatable pathogens, such as group A str eptococci and staphylococci. Rapid emergence of multiple-drug resistan ce has been documented in individual patients during therapy and in po pulations and environments with strong selective pressure from antimic robial agents, especially the cephalosporins. Therapeutic options for patients infected with multiply resistant strains have become severely limited. Carbapenems or, alternatively, fluoroquinolones are the most predictively active options, although resistance to both classes has been observed on rare occasions. Enterobacter spp, appear well adapted for survival and even proliferation as the turn of the century approa ches.