Emerging antimicrobial resistance in the surgical compromised host

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Advances in critical care prolong survival for compromised patients, leading to prolonged ICU stays.
• Repeated antibiotic courses in ICU settings foster colonization with multidrug-resistant pathogens.
• Surgical wound infections are becoming increasingly challenging to treat due to resistant organisms.

Purpose of the Study:

• To highlight the growing threat of multidrug-resistant pathogens in ICU patients.
• To discuss the implications for treating surgical wound infections.
• To review current and future challenges in antibiotic therapy for surgical infections.

Main Methods:

• Review of current literature on multidrug-resistant pathogens in intensive care units.
• Analysis of common resistant organisms including Methicillin-resistant Staphylococcus aureus, Klebsiella spp., Acinetobacter spp., and vancomycin-resistant enterococci.
• Examination of factors contributing to pathogen resistance, such as antibiotic use.

Main Results:

• Methicillin-resistant Staphylococcus aureus is prevalent, with geographic variations.
• Multidrug-resistant Klebsiella spp. are a significant cause of septicemia, linked to cephalosporin use.
• Acinetobacter spp. and vancomycin-resistant enterococci cause pan-resistant infections, with increasing prevalence.

Conclusions:

• Effective control measures include stringent hand hygiene, universal precautions, isolation, and judicious antibiotic policies.
• Antibiotic rotation and restrictive policies are recommended to combat resistance.
• The future of antibiotic treatment and prophylaxis for surgical infections is uncertain, despite ongoing research into new agents.