Abstract
In the first half of the decade of the 1990s, we in the United States have seen the emergence and escalation of substantial antimicrobial resistance in medically important gram-positive cocci. The incidence of methicillin resistance of Staphylococcus aureus continues to increase (now 18%), resulting in many more isolates that are multiply resistant; all S aureus isolates are still susceptible to vancomycin. Enterococci, particularly Enterococcus faecium, have increasingly developed resistance to penicillin, gentamicin, streptomycin, and vancomycin (the last plasmid-mediated). More than a fourth of Streptococcus pneumoniae strains are now resistant to penicillin, and these strains tend to be multiply resistant, including to cephalosporins and macrolides.
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