EPIDEMIOLOGY OF EMERGING RE-EMERGING ANTIMICROBIAL-RESISTANT BACTERIAL PATHOGENS/

The rapid global expansion of bacteria resistant to antimicrobials is the most important development over the past year in emerging bacteria l diseases. The critical events are the emergence of Staphylococcus au reus with decreased sensitivity to vancomycin, worldwide resistance to penicillin in Streptococcus pneumoniae, and the remorseless progressi on of multiply-resistant Mycobacterium tuberculosis. Most startling wa s the isolation from a human in Madagascar of a plague bacillus posses sing a plasmid readily transferable to Escherichia coli, which confers multiple antibiotic resistance. The hospital environment continues to see the transmission of resistant organisms, notably vancomycin-resis tant enterococci. Finally, as food markets become more open around the world, food-borne outbreaks of E. coli O157 and cholera demonstrate h ow difficult it can be to establish effective health and safety barrie rs.