Emerging resistant Gram-negative aerobic bacilli in hospital-acquired infections

Chemotherapy. 2010;56(6):492-500. doi: 10.1159/000321018. Epub 2010 Nov 24.

Abstract

The increasing emergence of serious multidrug-resistant (MDR) Gram-negative infections has led to a new health-care crisis. These infections predominately include MDR Pseudomonas aeruginosa, extended-spectrum beta-lactamase-producing Enterobacteriaceae and MDR Acinetobacter baumannii. These organisms are present in a variety of clinical settings, but there is a distinct paucity of antibiotics to effectively treat these infections. The increasing use of broad-spectrum antibiotics and lack of good stewardship have contributed to the increase in these MDR organisms. This review focuses on the main MDR Gram-negative infections contributing to the current crisis in health care, their mechanisms of resistance and various treatment options for empiric therapy.

Publication types

  • Review

MeSH terms

  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / epidemiology
  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / enzymology
  • Acinetobacter baumannii / pathogenicity
  • Anti-Bacterial Agents / pharmacology*
  • Cross Infection / drug therapy*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Drug Resistance, Multiple, Bacterial*
  • Gram-Negative Aerobic Bacteria / drug effects*
  • Gram-Negative Aerobic Bacteria / enzymology
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Negative Bacterial Infections / microbiology*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / epidemiology
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / enzymology
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases