Dangerous Pathogen Streptococcus Pyogenes - Essay Example

Article Synopsis and Review A common disease-causing agent around the world is known as Streptococcus pyogenes, which is responsible for causing manydiseases. Of these diseases, pharyngitis is the most common to be caused by S. pyogenes along with known cases of bacteremia and nectrotizing fasciitis. There are many different ways to kill the strains of S. pyogenes too cure an infected individual. The article by Rowe et al. focused on the multiple methods for eliminated these strains within humans that were primarily focused within the areas of northern Utah. Ultimately, the information discovered verified that these strains of disease-causing agents are highly susceptible to penicillin, and has minor resistance to macrolides as a form of treatment. The number one way to eliminate the presence of S. pyogenes strains is through the treatment of medicines from the penicillin family because of the tendency for the strains to have a high sensitivity to penicillin. Unfortunately, a very serious problem arises when the infected individual is allergic to penicillin. This forces many medical professionals to examine alternative methods of treating S. pyogenes that also reduces the possibility for developing very serious diseases from the strains. The most common alternative method is found in macrolides, which are antimicobials. Usually, erythromycin is used as a common macrolide treatment for known existence of S. pyogenes strains. Macrolides tend to have similar impact on the presence of these strains and has shown a major reduction of the disease-causing agents within infected persons. However, there is a growing problem where S. pyogenes strains are developing a high resistance rate in known cases throughout the world. Healthcare providers are showing a strong concern for the growing rates of resistance that S. pyogenes strains are showing towards macrolide treatment methods. “In Europe, studies have reported resistance to macrolides in more than 10% of strains tested from patients with S. pyogenes infections” (Rowe et al., 2009, p. 35). Unfortunately, there are even greater occurrences in specific European countries that has made many medical professionals interested in the high rates of resistance. “Studies conducted in Spain and Italy have reported resistance rates of 25% and 38%, respectively … Resistance in the United States has been reported as being somewhat lower than in European countries, ranging from three percent to nine percent” (Rowe, et al., 2009, p. 35). Typically, American cases have not shown large rates of S. pyogenes resistance, but many medical professionals are interested in studying the common causes of resistance and precise prevalence in order to determine proper ways of treating the disease-causing agents. The researchers that published this article on S. pyogenes infections, established a nation-wide study of treatment methods and a specific, more localized study performed in northern Utah. The researchers determined evidence that found that there are two main causes of resistance tendencies within strains of S. pyogenes. Some resistant strains have developed a two specific efflux mechanisms that reduce the ability of macrolides to eliminate the disease-causing agents. One of these efflux mechanisms exists “where the bacterium utilizes a membrane associated protein that pumps the macrolide out of the cell, severely reducing the antimicrobial effect. This membrane protein is specific for macrolides” (Rowe et al., 2009, p. 36). In other words, the efflux mechanism causes a specific protein membrane that takes the macrolide solution and pumps it out of the cell in order to protect the S. pyogenes strains. This is not a rare occurrence for many disease-causing agents that have evolved a protective mechanism to protect against current medicines and treatments that kill the agents. A second efflux mechanism exists for resistance of the S. pyogenes strains against different forms of macrolide treatment. This treatment is prevalent within the bacterial ribosomes of the strains that had modified over time to form a strong resistance. “Bacteria with this mechanism produce an enzyme that adds a methyl (-CH3) group on the ribosome. This methylation slightly changes the shape of the ribosome and reduces the affinity of the drug for the ribosome” (Rowe et al., 2009, p. 36). Similar to the first mechanism, this process has produced additional methyl into the ribosome and causes the S. pyogenes to have a strong affinity for macrolides. The researchers suggest that these two evolutionary mechanisms have formulated due to medical professionals over-prescribing macrolides for a number of different everyday diseases (Rowe et al., 2009, p. 37). Nevertheless, additional research is decessary to determine the precise resistance rates of S. pyogenes in infected individuals, especially within the United States. The researchers developed a study that examined subjects that had been infected with S. pyogenes within the geographic areas of northern Utah. The study was designed to subject 739 infected individuals to treatment methods of penicillin and macrolides, specifically using erythromycin to represent this form of treatment. Subjects were observed and treated for several weeks and the results were recorded and analyzed by the researchers at Weber State University in the Department of Clinical Laboratory Sciences. The results showed absolutely no cases of resistance to the treatment of penicillin, which validated previous research on the ability of penicillin to significantly reduce S. pyogenes. On the other hand, there were minimal cases of resistance shown toward the macrolides treatments. In total, over 2.4% of the treated subjects showed resistance tendencies to erythromycin macrolides (Rowe et al., 2009, p. 39). Although this rate is not as significant as some of the previously reported rates in European countries, it does raise a large concern for resistance rates within the United States as macrolides may not always be able to significantly reduce the strains of S. pyogenes. This research article is highly significant to Advanced Pratice Nurses because of the resistance tendencies within individuals that have been infected by S. pyogenes disease-causing agents. A number of diseases are caused by these strains and there is highly significant research to show that medicines from the penicillin family are highly effective in reducing and eliminating the strains within infected persons. However, as APN professionals seek out a medical history of the patient and determine any possible allergic reaction to penicillin, they will be able to determine alternative methods for treating these strains. Macrolides, and more specifically erythromycin, show high rates of reducing the prevalence and growth of S. pyogenes. Unfortunately, this treatment method is not 100% effective due to the resistance mechanisms that these strains have developed, presumably caused by medical professionals over-prescribing the medicines for such diseases. APN professionals must understand that macrolides are the next highly effective form of treatment for S. pyogenes, but there is a small tendency for resistance. The shockingly large rates of resistance in European countries interests many researchers to determine why they are so high, when the resistance rates in the United States are typically only around 3% of infected individuals. This article provided an interesting insight into alternative treatment methods for a major disease-causing agent in the United States and abroad. The goal is always to find a method for curing infected persons, and when the existence of allergies negatively impacts the ability to use popular treatment methods, APNs and other medical professionals within the pharmacology industry must find different ways to accommodate. The large differences between resistance rates reported within the United States and abroad cause a large curiosity within the medical profession and require that further research is performed on the resistance rates that disease-causing agents have acquired to macrolides treatment methods. Nevertheless, the researchers have touched on an important subject within the healthcare profession and specifically with APNs that must continue to find alternative treatment methods for diseases to avoid evolutionary resistance mechanisms and any other human characteristic, such as allergies, that may negatively impact the ability to use popular treatment methods. References Rowe, R., Stephenson, R., East, D., & Wright, S. (2009). Mechanisms of resistance for Streptococcus pyogenes in northern Utah. Clinical Laboratory Science: Journal Of The American Society For Medical Technology, 22(1), 39-44. Read More